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Abstract
Objective: The aim of this report was to examine the accuracy of diagnosing substance use disorders in manic adolescents with bipolar disorder. Methods: The substance use disorder modules of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL) were administered to a sample of 80 manic adolescents (12 to 21 years old) with co-occurring bipolar and substance use disorders. Initial substance use disorder diagnoses obtained from the K-SADS-PL were then compared to a best estimate diagnosis derived from all available information, including a second diagnostic interview, the Child Semi-Structured Assessment for the Genetics of Alcoholism, Adolescent version (C-SSAGA-A). Results: Relatively low diagnostic agreement was achieved across the initial and the best estimate diagnoses for both alcohol and cannabis use disorders. Age, race, and sex did not predict diagnostic agreement between the two evaluations. Conclusions: Results of this study call for more research on diagnosing substance use disorders and suggest that a single interview alone may not be accurate for diagnosing substance use disorders in manic adolescents with bipolar disorder.
ACKNOWLEDGMENTS
We would like to acknowledge Shaohong Zheng, MBA, for her assistance with data management. This work was supported by a National Institute on Drug Abuse (NIDA) grant # DA022221 (Melissa P. DelBello) and by a National Institute on Alcohol Abuse and Alcoholism (NIAAA) grant # AA016372 (Melissa P. DelBello). The writing of this manuscript was supported, in part, by NIDA grant # DA026517 (Jaimee L. Heffner) and by the Department of Veterans Affairs. Findings from this article were presented by Dr. Melissa DelBello at the annual meeting of the American Academy of Child and Adolescent Psychiatry, October 18–23, 2011, in Toronto, Canada.