Clinical Pathway Program
The Clinician Pathway Program is a diagnostic assessment program for Juvenile Bipolar Disorder. The Diagnostic Assessment Program for Juvenile Bipolar Disorder is designed for use in clinical and research settings to screen for bipolar disorder in children from parent and child reports. The program provides preliminary diagnostic and symptom severity measures, as well as scaled scores of other key symptom dimensions (anxiety, sleep/wake disturbance, mania, sensory sensitivity and others). It includes two easy-to-use self-administered questionnaires:
- The Child Bipolar Questionnaire (CBQ) for parents and
- The Jeannie and Jeffrey Illustrated Interview for Children (J/J)
The CBQ has collected profile data on over 19,000 children with a community diagnosis of bipolar disorder or at risk for the disorder. The large numbers of subject profiles have allowed investigators to:
- Identify a highly heritable trait of the disorder
- Identify a new view of the disorder based on behavioral dimensions
- Determine the heritability of the resulting dimensions through concordance analysis
- Further refine and investigate the most salient heritable features
- Arrive at a highly refined, clinically homogeneous and heritable phenotype, called the FOH phenotype, which can easily be identified by 4 factors of the CBQ with 96% accuracy.
- Propose a hypothesis of the underlying biology of the FOH phenotype as well as identify a potential biomarker for the illness.
The effectiveness of the CBQ to rapidly, inexpensively and accurately identify phenotypes of pediatric bipolar disorder eliminates obstacles posed by previous screening and diagnostic instruments. Additionally, the inherent flexibility of the CBQ ensures that it will continue to be a means to identify other behavioral subtypes in the future. The broad scope of symptoms it captures can be examined and re-examined under the focus of different lenses. As the field of psychiatric research moves more into a dimensional, rather than categorical framework, the data will stand ready to continue yielding specific subtypes that can lead to more insight and better, more targeted treatment.
