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Pain, Progress, and Promise in the Assessment of Bipolar Disorder from Childhood to Emerging Adulthood

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Presented by Eric Youngstrom, PhD

Date:

Bipolar disorders can be among the most debilitating conditions, with recurrent impairment and increased mortality. Both biological and environmental factors unequivocally contribute to risk. Yet despite the clear public and clinical need, and the prominent role of genetic and early environmental risk exposures, diagnostic accuracy typically has been abysmal.

Pain points have included the complexity of presentations, stigma around mental health issues and bipolar disorder in particular, persistent skepticism about diagnosis in youth, and a lack of awareness and implementation of validated tools and methods to improve recognition and treatment matching.

Progress over two decades includes better understanding of phenomenology, prevalence, diagnosis, longitudinal course, and assessment methodology. The literature now supports meta-analyses and practice guidelines. It also has been thorough in comparing the value added by different stakeholder perspectives, including parent and teacher report and clinical interview and observations in addition to self-report.

There is a suite of tools, including a brief family history screening, free self- and caregiver-report scales, and substantially updated interview tools and mood tracking methods, that are sufficiently validated to warrant widespread clinical usage.

These advances have not yet peaked in terms of families helped. Areas of promise include more large-scale dissemination and implementation support, using nontraditional platforms such as YouTube, Wikipedia, Wikiversity, and open science practices. Translating the measures and sharing scoring and statistical code can reduce barriers for engagement in low-resource communities. This talk itself will share slides and links to obtain copies of the best of the free tools reviewed.