The Experts below are selected from a list of 5166 Experts worldwide ranked by ideXlab platform
Mauricio Tohen - One of the best experts on this subject based on the ideXlab platform.
-
young Mania Rating Scale how to interpret the numbers determination of a severity threshold and of the minimal clinically significant difference in the emblem cohort
International Journal of Methods in Psychiatric Research, 2013Co-Authors: Michael Lukasiewicz, Stephanie Gerard, Adeline Besnard, Elena Perrin, Helene Sapin, Catherine Reed, Mauricio Tohen, Bruno Falissard, Jean Michel AzorinAbstract:The aim of this analysis was to identify Young Mania Rating Scale (YMRS) meaningful benchmarks for clinicians (severity threshold, minimal clinically significant difference [MCSD]) using the Clinical Global Impressions Bipolar (CGI-BP) Mania Scale, to provide a clinical perspective to randomized clinical trials (RCTs) results. We used the cohort of patients with acute manic/mixed state of bipolar disorders (N = 3459) included in the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) study. A receiver-opeRating characteristic analysis was performed on randomly selected patients to determine the YMRS optimal severity threshold with CGI-BP Mania score ≥ “Markedly ill” defining severity. The MCSD (clinically meaningful change in score relative to one point difference in CGI-BP Mania for outcome measures) of YMRS, was assessed with a linear regression on baseline data. At baseline, YMRS mean score was 26.4 (±9.9), CGI-BP Mania mean score was 4.8 (±1.0) and 61.7% of patients had a score ≥ 5. The optimal YMRS severity threshold of 25 (positive predictive value [PPV] = 83.0%; negative predictive value [NPV] = 66.0%) was determined. In this cohort, a YMRS score of 20 (typical cutoff for RCTs inclusion criteria) corresponds to a PPV of 74.6% and to a NPV of 77.6%, meaning that the majority of patients included would be classified as severely ill. The YMRS minimal clinically significant difference was 6.6 points. Copyright © 2013 John Wiley & Sons, Ltd.
-
olanzapine versus placebo in the treatment of adolescents with bipolar Mania
American Journal of Psychiatry, 2007Co-Authors: Mauricio Tohen, Robert L Findling, Melissa P. Delbello, Janet Wozniak, Ludmila Kryzhanovskaya, Gabrielle A Carlson, Robert A Kowatch, Karen Dineen Wagner, Daniel W Lin, C RobertsonplouchAbstract:Objective: The purpose of this study was to evaluate the efficacy and safety of olanzapine for the treatment of acute manic or mixed episodes associated with bipolar disorder in adolescents. Method: A 3-week multicenter, parallel, double-blind, randomized placebo-controlled trial was conducted at 24 sites in the United States and two sites in Puerto Rico. The participants were outpatient and inpatient male and female adolescents 13–17 years of age with an acute manic or mixed episode. Subjects received either olanzapine (2.5–20 mg/day [N=107]) or placebo (N=54). The mean change from baseline to endpoint in the Young Mania Rating Scale total score was the primary outcome measure. Results: The mean baseline-to-endpoint change in the Young Mania Rating Scale total score was significantly greater for patients receiving olanzapine relative to patients receiving placebo, and a greater proportion of olanzapine-treated patients met response and remission criteria (44.8% versus 18.5% and 35.2% versus 11.1%, respec...
-
olanzapine versus divalproex sodium for the treatment of acute Mania and maintenance of remission a 47 week study
American Journal of Psychiatry, 2003Co-Authors: Mauricio Tohen, Lori L Altshuler, Carlos A Zarate, Trisha Suppes, Terrence A Ketter, R C Risser, Mark A Frye, John Zajecka, Leslie M Schuh, Eileen BrownAbstract:OBJECTIVE: Few double-blind trials have compared longer-term efficacy and safety of medications for bipolar disorder. The authors report a 47-week comparison of olanzapine and divalproex. METHOD: This 47-week, randomized, double-blind study compared flexibly dosed olanzapine (5–20 mg/day) to divalproex (500–2500 mg/day) for manic or mixed episodes of bipolar disorder (N=251). The only other psychoactive medication allowed was lorazepam for agitation. The primary efficacy instrument was the Young Mania Rating Scale; a priori protocol-defined threshold scores were ≥20 for inclusion, ≤12 for remission, and ≥15 for relapse. Analytical techniques included mixed model repeated-measures analysis of variance for change from baseline, Fisher’s exact test (two-tailed) for categorical comparisons, and Kaplan-Meier estimates of time to events of interest. RESULTS: Over 47 weeks, mean improvement in Young Mania Rating Scale score was significantly greater for the olanzapine group. Median time to symptomatic Mania remi...
-
olanzapine versus divalproex in the treatment of acute Mania
American Journal of Psychiatry, 2002Co-Authors: Mauricio Tohen, Lori L Altshuler, Robert W Baker, Carlos A Zarate, Trisha Suppes, Terrence A Ketter, Denai R Milton, R C Risser, J A Gilmore, Alan BreierAbstract:OBJECTIVE: The effects of olanzapine and divalproex for the treatment of Mania were compared in a large randomized clinical trial. METHOD: A 3-week, randomized, double-blind trial compared flexibly dosed olanzapine (5–20 mg/day) to divalproex (500–2500 mg/day in divided doses) for the treatment of patients hospitalized for acute bipolar manic or mixed episodes. The Young Mania Rating Scale and the Hamilton Depression Rating Scale were used to quantify manic and depressive symptoms, respectively. Safety was assessed with several measures. RESULTS: The protocol defined baseline-to-endpoint improvement in the mean total score on the Young Mania Rating Scale as the primary outcome variable. The mean Young Mania Rating Scale score decreased by 13.4 for patients treated with olanzapine (N=125) and 10.4 for those treated with divalproex (N=123). A priori categorizations defined response and remission rates: 54.4% of olanzapine-treated patients responded (≥50% reduction in Young Mania Rating Scale score), compare...
-
olanzapine versus placebo in the treatment of acute Mania
American Journal of Psychiatry, 1999Co-Authors: Mauricio Tohen, T M Sanger, Susan L Mcelroy, G D Tollefson, K N R Chengappa, D G Daniel, Frederick Petty, Franca Centorrino, R Wang, S L GrundyAbstract:OBJECTIVE: The primary intent of this study was to compare the efficacy and safety of olanzapine and placebo in the treatment of acute Mania. METHOD: The design involved a random-assignment, double-blind, placebo-controlled parallel group study of 3 weeks’ duration. After a 2- to 4-day screening period, qualified patients were assigned to either olanzapine (N=70) or placebo (N=69). Patients began double-blind therapy with either olanzapine, 10 mg, or placebo given once per day. After the first day of treatment, the daily dose could be adjusted upward or downward, as clinically indicated, by one capsule (olanzapine, 5 mg/day) within the allowed range of one to four capsules. The primary efficacy measure in the protocol was defined as a change from baseline to endpoint in total score on the Young Mania Rating Scale. Clinical response was defined a priori as a decrease of 50% or more from baseline in Young Mania Rating Scale total score. RESULTS: The olanzapine group experienced significantly greater mean im...
Joseph R Calabrese - One of the best experts on this subject based on the ideXlab platform.
-
Evaluation and comparison of psychometric instruments for pediatric bipolar spectrum disorders in four age groups.
Journal of child and adolescent psychopharmacology, 2007Co-Authors: Thomas W. Frazier, Eric A. Youngstrom, Joseph R Calabrese, Christine A. Demeter, Robert J. Stansbrey, Nora K. Mcnamara, Robert L FindlingAbstract:The primary objective of this study was to evaluate the psychometric characteristics of the Young Mania Rating Scale (YMRS), the K-SADS Mania Rating Scale (KMRS), and the Children's Depression Rating Scale-Revised (CDRS-R) across four age groups (4-7, 8-10, 11-13, and 14-17 years). The interrater reliability of K-SADS diagnoses was also examined. Participants included 1,014 youths (62.1% male) presenting to an outpatient clinical research center. Diagnoses were based upon semistructured K-SADS interviews. Symptomatic assessments and Ratings of psychosocial functioning were completed following the diagnostic interview. Mania measures showed unifactorial structure and good internal consistency reliability (alpha = 0.79-0.95) across all ages groups. The CDRS-R factor structure shifted from one to two factors in adolescents. For all ages and symptom measures, reliability was excellent in the range where differential diagnosis is most difficult. Efficiencies in discriminating bipolar spectrum disorders from other disorders were excellent (areas under the curve, AUCs = 0.92-0.99) for Mania measures, with comparable discrimination across age groups. Interrater reliability of K-SADS diagnoses was excellent across age groups (smallest kappa = 0.95). Results indicate that Mania measures are useful for assessing symptoms across a wide range of ages. The CDRS-R may be better conceptualized as a two-factor measure in older adolescents. The semistructured K-SADS interview can be used to generate reliable diagnoses across a broad age range.
-
toward an integration of parent and clinician report on the young Mania Rating Scale
Journal of Affective Disorders, 2003Co-Authors: Eric A. Youngstrom, Barbara L Gracious, Robert L Findling, Carla Kmett Danielson, Joseph R CalabreseAbstract:Abstract Background: The Young Mania Rating Scale (YMRS) has validity in the assessment of Mania in adults. The purpose of this study was to examine how the YMRS might optimally be used in the assessment of youths. Methods: Children and adolescents between the ages of 5 and 17 years of age participated in this study. All youths were evaluated with the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). Based on the K-SADS results, subjects were then assigned to one of five groups: a bipolar I group, another bipolar spectrum group, a depressive disorders group, a disruptive behaviors disorders group, and a no diagnosis group. Guardians completed a version of the YMRS modified for parent reporting. Clinicians completed the YMRS on all participating youths. Results: Both parent and clinician Ratings on the YMRS assigned patients ( n =117) to the appropriate diagnostic group with 71–98% accuracy. Combining information from multiple informants did not significantly improve diagnostic group assignment. Limitations: The same raters completed the clinician YMRS and the K-SADS interview involving the parent. Findings need replication in an independent sample with lower base rates of bipolar disorder, less rigorously trained and supervised raters, and using a prospective design to provide maximum generalizability of results. Current results should be interpreted as a ‘best case’ scenario. Conclusions: These data suggest that the YMRS may be a useful adjunct in assessing the severity of Mania in youths. Tentative cutting scores are proposed to maximize efficiency, sensitivity, and specificity.
-
preliminary communication toward an integration of parent and clinician report on the young Mania Rating Scale
2003Co-Authors: Eric A. Youngstrom, Barbara L Gracious, Robert L Findling, Carla Kmett Danielson, Joseph R CalabreseAbstract:Background: The Young Mania Rating Scale (YMRS) has validity in the assessment of Mania in adults. The purpose of this study was to examine how the YMRS might optimally be used in the assessment of youths. Methods: Children and adolescents between the ages of 5 and 17 years of age participated in this study. All youths were evaluated with the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). Based on the K-SADS results, subjects were then assigned to one of five groups: a bipolar I group, another bipolar spectrum group, a depressive disorders group, a disruptive behaviors disorders group, and a no diagnosis group. Guardians completed a version of the YMRS modified for parent reporting. Clinicians completed the YMRS on all participating youths. Results: Both parent and clinician Ratings on the YMRS assigned patients (n=117) to the appropriate diagnostic group with 71–98% accuracy. Combining information from multiple informants did not significantly improve diagnostic group assignment. Limitations: The same raters completed the clinician YMRS and the K-SADS interview involving the parent. Findings need replication in an independent sample with lower base rates of bipolar disorder, less rigorously trained and supervised raters, and using a prospective design to provide maximum generalizability of results. Current results should be interpreted as a ‘best case’ scenario. Conclusions: These data suggest that the YMRS may be a useful adjunct in assessing the severity of Mania in youths. Tentative cutting scores are proposed to maximize efficiency, sensitivity, and specificity. D 2002 Elsevier B.V. All rights reserved.
-
discriminative validity of a parent version of the young Mania Rating Scale
Journal of the American Academy of Child and Adolescent Psychiatry, 2002Co-Authors: Eric A. Youngstrom, Barbara L Gracious, Robert L Findling, Joseph R CalabreseAbstract:ABSTRACT Objective: To examine the usefulness of a parent report version of the Young Mania Rating Scale (P-YMRS) in distinguishing bipolar disorder from other mental health conditions in children and adolescents. Method: Parents of 117 youths aged 5 to 17 years presenting to an outpatient research center completed an adapted Young Mania Rating Scale (P-YMRS). Eligible subjects underwent a diagnostic evaluation including a semistructured instrument (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and also a clinical evaluation by a child and adolescent psychiatrist in more than 75% of the subjects. Results: Factor analyses of the P-YMRS suggested one dimension, with a total score showing acceptable internal consistency (α = .75). Logistic regressions discriminated bipolar mood disorder versus unipolar disorder, versus disruptive behavior disorder, and versus any other diagnosis. Classification rates exceeded 78%, and receiver opeRating characteristics analyses showed good diagnostic efficiency, with areas under the curve greater than 0.82. Conclusions: The P-YMRS may be used to derive clinically meaningful information about mood disorders in youths.
-
factor structure of the young Mania Rating Scale for use with youths ages 5 to 17 years
Journal of Clinical Child and Adolescent Psychology, 2002Co-Authors: Eric A. Youngstrom, Barbara L Gracious, Robert L Findling, Carla Kmett Danielson, Joseph R CalabreseAbstract:Assessed the factor structure of the Young Mania Rating Scale (YMRS). Youths presenting to a research program specializing in the pharmacological treatment of mood and disruptive behavioral disorders (N = 612) were administered a semistructured diagnostic interview. Based on the interview, youths were placed into diagnostic groups. Highly trained raters completed the YMRS for each youth. YMRS Ratings were internally consistent (a = .91), and exploratory and confirmatory factor analyses yielded a 1-factor solution for boys and girls in both young (5 to 11 years) and older (12 to 17 years) subsamples. However, the young male group showed higher scores on several items as well as the total YMRS score. Results suggest that the YMRS total score can be meaningfully interpreted in child and adolescent samples.
Eric A. Youngstrom - One of the best experts on this subject based on the ideXlab platform.
-
accuracy of brief and full forms of the child Mania Rating Scale
Journal of Clinical Psychology, 2008Co-Authors: David B Henry, Eric A. Youngstrom, Mani N Pavuluri, Boris BirmaherAbstract:This study assesses the sensitivity of full and brief forms of a parent-rated Mania Scale to variations in diagnoses. Parents of a sample of 150 subjects either diagnosed with bipolar disorder (BD) or attention deficit hyperactivity disorder (ADHD), or healthy controls (HC), completed the full Child Mania Rating Scale and other measures. We used single-parameter item-response theory models to produce a brief parent Mania Rating Scale from the full version. The 10-item, brief Child Mania Rating Scale—Parent (CMRS-P) version correlated .93 with 11 items from the full CMRS-P that were not used in constructing the brief version, and showed accuracy comparable to the full Scale in differentiating BD from ADHD, and in discriminating among bipolar subtypes. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64:1–14, 2008.
-
Comparing the psychometric properties of multiple teacher report instruments as predictors of bipolar disorder in children and adolescents.
Journal of clinical psychology, 2008Co-Authors: Eric A. Youngstrom, Megan F. Joseph, Jamelle GreeneAbstract:The psychometric properties of four teacher report measures and their utility for accurate diagnosis of pediatric bipolar spectrum disorders (BPSDs) were examined. Participants were 191 youth (65% male; 62% African-American; 23% diagnosed with a BPSD), age 5-18 (M=10.16, SD=3.27) years, 70% recruited from a community mental health center and 30% recruited from a mood disorders clinic. Teachers "who knew the child best" were asked to complete the Achenbach Teacher Report Form (TRF) as well as teacher versions of the General Behavior Inventory (T-GBI), the Child Mania Rating Scale (CMRS-T), and the Young Mania Rating Scale (T-YMRS). Teacher response rates and missing data varied significantly depending on the age of the child. Exploratory factor analysis identified stable and interpretable factors; however, receiver opeRating characteristic (ROC) and logistic regression analyses showed that teacher report measures were not able to discriminate BPSD cases from non-BPSD cases, or from attention deficit hyperactivity disorder (ADHD) cases. Teacher report appears to be insufficiently specific or sensitive to BPSD for clinical diagnostic use, although teacher Scales might have research utility.
-
Response and remission in adolescent Mania: Signal detection analyses of the young Mania Rating Scale
Journal of the American Academy of Child and Adolescent Psychiatry, 2007Co-Authors: Nick C. Patel, Eric A. Youngstrom, Danielle M. Patrick, Stephen M. Strakowski, Melissa P. DelbelloAbstract:ABSTRACT Objective: The purpose of this study was to determine optimal criteria for defining response and remission in adolescents with acute Mania. Method: Data were analyzed from three treatment studies of adolescents with acute Mania ( N = 99). Trained raters completed the Young Mania Rating Scale (YMRS), and clinicians completed the Clinical Global Impressions Scale for Bipolar Disorder (CGI-BP) independent of YMRS Ratings. For response, the percentages of reduction in YMRS scores from baseline to endpoint were compared with CGI-BP Mania Improvement scores. For remission, endpoint YMRS scores were compared with CGI-BP Mania Severity scores. Signal detection analyses were conducted to evaluate the efficiency of selected cutoffs associated with response and remission. Results: A ≥55% reduction in YMRS scores from baseline to endpoint was the optimal cutoff defining response. An absolute endpoint YMRS score ≤12 was the optimal cutoff defining remission. Conclusions: The results of this signal detection analysis in adolescent Mania suggest that current commonly used cutoffs to define response (≥50% reduction) and remission (≤12) may be appropriate with regard to efficiency. Studies with methods specifically tailored to evaluate and compare these Rating Scales and larger patient samples from multiple sites are needed to confirm these preliminary findings.
-
Evaluation and comparison of psychometric instruments for pediatric bipolar spectrum disorders in four age groups.
Journal of child and adolescent psychopharmacology, 2007Co-Authors: Thomas W. Frazier, Eric A. Youngstrom, Joseph R Calabrese, Christine A. Demeter, Robert J. Stansbrey, Nora K. Mcnamara, Robert L FindlingAbstract:The primary objective of this study was to evaluate the psychometric characteristics of the Young Mania Rating Scale (YMRS), the K-SADS Mania Rating Scale (KMRS), and the Children's Depression Rating Scale-Revised (CDRS-R) across four age groups (4-7, 8-10, 11-13, and 14-17 years). The interrater reliability of K-SADS diagnoses was also examined. Participants included 1,014 youths (62.1% male) presenting to an outpatient clinical research center. Diagnoses were based upon semistructured K-SADS interviews. Symptomatic assessments and Ratings of psychosocial functioning were completed following the diagnostic interview. Mania measures showed unifactorial structure and good internal consistency reliability (alpha = 0.79-0.95) across all ages groups. The CDRS-R factor structure shifted from one to two factors in adolescents. For all ages and symptom measures, reliability was excellent in the range where differential diagnosis is most difficult. Efficiencies in discriminating bipolar spectrum disorders from other disorders were excellent (areas under the curve, AUCs = 0.92-0.99) for Mania measures, with comparable discrimination across age groups. Interrater reliability of K-SADS diagnoses was excellent across age groups (smallest kappa = 0.95). Results indicate that Mania measures are useful for assessing symptoms across a wide range of ages. The CDRS-R may be better conceptualized as a two-factor measure in older adolescents. The semistructured K-SADS interview can be used to generate reliable diagnoses across a broad age range.
-
toward an integration of parent and clinician report on the young Mania Rating Scale
Journal of Affective Disorders, 2003Co-Authors: Eric A. Youngstrom, Barbara L Gracious, Robert L Findling, Carla Kmett Danielson, Joseph R CalabreseAbstract:Abstract Background: The Young Mania Rating Scale (YMRS) has validity in the assessment of Mania in adults. The purpose of this study was to examine how the YMRS might optimally be used in the assessment of youths. Methods: Children and adolescents between the ages of 5 and 17 years of age participated in this study. All youths were evaluated with the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). Based on the K-SADS results, subjects were then assigned to one of five groups: a bipolar I group, another bipolar spectrum group, a depressive disorders group, a disruptive behaviors disorders group, and a no diagnosis group. Guardians completed a version of the YMRS modified for parent reporting. Clinicians completed the YMRS on all participating youths. Results: Both parent and clinician Ratings on the YMRS assigned patients ( n =117) to the appropriate diagnostic group with 71–98% accuracy. Combining information from multiple informants did not significantly improve diagnostic group assignment. Limitations: The same raters completed the clinician YMRS and the K-SADS interview involving the parent. Findings need replication in an independent sample with lower base rates of bipolar disorder, less rigorously trained and supervised raters, and using a prospective design to provide maximum generalizability of results. Current results should be interpreted as a ‘best case’ scenario. Conclusions: These data suggest that the YMRS may be a useful adjunct in assessing the severity of Mania in youths. Tentative cutting scores are proposed to maximize efficiency, sensitivity, and specificity.
Charles L. Bowden - One of the best experts on this subject based on the ideXlab platform.
-
Relative effectiveness of adjunctive risperidone on manic and depressive symptoms in mixed Mania.
International clinical psychopharmacology, 2013Co-Authors: Vivek Singh, Charles L. Bowden, Jim MintzAbstract:Mixed states are common and severe manifestations of bipolar disorder, with limited data on the differential efficacy of treatments on depressive and manic symptoms. This study assessed the effectiveness of open-label adjunctive risperidone in achieving sustained effectiveness in patients with mixed Mania, with a specific focus on the differential benefits on manic and depressive symptomatology. Forty patients with bipolar disorder I, currently in a mixed manic episode, were treated with adjunctive risperidone. Behavioral measures at baseline and weeks 1, 2, 4, 8, 12, 16, and 20 were assessed using the following Scales: the Young Mania Rating Scale, the Montgomery Asberg Depression Rating Scale (MADRS), and the Global Assessment Scale. The primary outcome measure was the proportion of patients who attained a sustained response on either depressive or manic symptomatology, defined as at least 50% reduction from the baseline on the Montgomery Asberg Depression Rating Scale or the Young Mania Rating Scale, maintained over at least 8 weeks without subsequent relapse during the 20-week trial. A significantly higher proportion of patients achieved a sustained response for Mania than depression, 16/40 versus 6/40, respectively (McNemar's χ² 8.33, P=0.004). Higher elevated mood at baseline and lower apparent sadness (P
-
Efficacy of valproate versus lithium in Mania or mixed Mania: A randomized, open 12-week trial
International clinical psychopharmacology, 2010Co-Authors: Charles L. Bowden, Ronnachai Kongsakon, Sergey Mosolov, Luchezar Hranov, Eric Y.h. Chen, Hussain Habil, Robert Manfredi, Hsin Nan LinAbstract:The objective of this study was to compare the efficacy and safety of valproate and lithium in bipolar I patients experiencing a manic or a mixed episode. This international, randomized, open-label, parallel-group, equivalence study included 268 patients with bipolar I disorder. The starting dose of valproate was 20 mg/kg/day and that of lithium was 800 mg/day. Treatment duration was 12 weeks. The primary outcome measure was mean change in Young Mania Rating Scale score between baseline and study end. Secondary outcome measures were response and remission rates, change in Montgomery and Asberg Depression Rating Scale and Clinical Global Impression Bipolar Disorder instrument score, and occurrence of adverse events. The mean change from baseline in Young Mania Rating Scale score was 15.8 +/- 5.3 in the lithium group and 17.3 +/- 9.4 in the valproate group. The 90 confidence interval of the intergroup difference (-0.69; 3.31) was within prespecified equivalence limits. Response rates were 72.6 in the lithium group and 79.5 in the valproate group. Remission rates were 58.5 and 71.9, respectively. No intergroup differences were observed in median time to treatment response (21 days) or change in Clinical Global Impression Bipolar Disorder instrument or Montgomery and Asberg Depression Rating Scale scores. Adverse events were reported in 42.8 of patients in the lithium group and 41.5 in the valproate group. Valproate and lithium showed comparable efficacy and tolerability in the treatment of acute Mania over 12 weeks. Int Clin Psychopharmacol 25: 60-67 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
-
combination of a mood stabilizer with risperidone or haloperidol for treatment of acute Mania a double blind placebo controlled comparison of efficacy and safety
American Journal of Psychiatry, 2002Co-Authors: Gary S Sachs, Fred Grossman, Nassir S Ghaemi, A Okamoto, Charles L. BowdenAbstract:OBJECTIVE: The study assessed the efficacy and safety of risperidone as an adjunctive agent to mood stabilizers in the treatment of acute Mania. METHOD: This 3-week randomized, double-blind, placebo-controlled study included 156 bipolar disorder patients with a current manic or mixed episode who received a mood stabilizer (lithium or divalproex) and placebo, risperidone, or haloperidol. The primary efficacy measure was the Young Mania Rating Scale. Other assessments used the Brief Psychiatric Rating Scale, the Clinical Global Impression Scale, and safety measures. RESULTS: The trial was discontinued by 25 (49%) of the 51 placebo group patients, 18 (35%) of the 52 risperidone group patients, and 28 (53%) of the 53 haloperidol group patients. Mean modal doses were 3.8 mg/day (SD=1.8) of risperidone and 6.2 mg/day (SD=2.9) of haloperidol. Significantly greater reductions in Young Mania Rating Scale scores at endpoint and over time were seen in the risperidone group and in the haloperidol group, compared with...
-
An open-label trial of divalproex in children and adolescents with bipolar disorder.
Journal of the American Academy of Child and Adolescent Psychiatry, 2002Co-Authors: Karen Dineen Wagner, Gary S Sachs, Elizabeth B Weller, Ronald A Weller, Joseph Biederman, Gabrielle A Carlson, Jean A. Frazier, Patricia Wozniak, Katherine A. Tracy, Charles L. BowdenAbstract:ABSTRACT Objective: This study evaluated the safety and effectiveness of divalproex sodium (Depakote ® ) in the treatment of youths with bipolar disorder. Method: Forty bipolar disorder patients aged 7 to 19 years, with a manic, hypomanic, or mixed episode, enrolled in an open-label study of divalproex (2–8 weeks), followed by a double-blind, placebo-controlled period (8 weeks). Results: Twenty-two subjects (61%) showed ≥50% improvement in Mania Rating Scale (MRS) scores during the open-label period. Significant ( p Conclusions: This study provides preliminary support for the safety and effectiveness of divalproex in the treatment of bipolar disorder in youths.
Mani N Pavuluri - One of the best experts on this subject based on the ideXlab platform.
-
child Mania Rating Scale parent version a valid measure of symptom change due to pharmacotherapy
Journal of Affective Disorders, 2011Co-Authors: Amy E West, David B Henry, Christine I Celio, Mani N PavuluriAbstract:Abstract Background The development of valid parent-report measures of symptom change in pediatric bipolar disorder (PBD) is imperative to evaluate the effectiveness of different treatment approaches; yet, few studies have tested the sensitivity of symptom measures. The current study evaluated the sensitivity of the Child Mania Rating Scale (CMRS-P) to detect symptom change over time in a treatment study for PBD. Methods Data on symptom change were drawn from a prospective six-week, double-blind, placebo-controlled, randomized outpatient medication treatment trial of risperidone versus divalproex. The sample included 66 children with Bipolar type I disorder. Measures were administered every week for six weeks of treatment. Results The CMRS-P demonstrated statistically (p ≤ .05) and clinically significant change in symptom report from pre to post-test. Growth curve modeling indicated that the CMRS-P demonstrated overall similarity to the YMRS in the magnitude and trajectory of change over time. Finally, results indicate that the CMRS-P is able to detect response rates with moderate levels of agreement with other measures. Limitations Limitations of this study include a relatively small sample size and uncertain generalizability beyond treatment trials. Conclusions The CMRS-P is short, easy to administer, and represents parent's report of symptoms, all strengths which make it a compelling treatment outcome tool. This preliminary evidence of its validity as a treatment outcome measure makes it applicable in other research settings and suggests its potential use in clinical settings.
-
Child Mania Rating Scale-Parent Version: a valid measure of symptom change due to pharmacotherapy.
Journal of affective disorders, 2010Co-Authors: Amy E West, David B Henry, Christine I Celio, Mani N PavuluriAbstract:The development of valid parent-report measures of symptom change in pediatric bipolar disorder (PBD) is imperative to evaluate the effectiveness of different treatment approaches; yet, few studies have tested the sensitivity of symptom measures. The current study evaluated the sensitivity of the Child Mania Rating Scale (CMRS-P) to detect symptom change over time in a treatment study for PBD. Data on symptom change were drawn from a prospective six-week, double-blind, placebo-controlled, randomized outpatient medication treatment trial of risperidone versus divalproex. The sample included 66 children with Bipolar type I disorder. Measures were administered every week for six weeks of treatment. The CMRS-P demonstrated statistically (p ≤ .05) and clinically significant change in symptom report from pre to post-test. Growth curve modeling indicated that the CMRS-P demonstrated overall similarity to the YMRS in the magnitude and trajectory of change over time. Finally, results indicate that the CMRS-P is able to detect response rates with moderate levels of agreement with other measures. Limitations of this study include a relatively small sample size and uncertain generalizability beyond treatment trials. The CMRS-P is short, easy to administer, and represents parent's report of symptoms, all strengths which make it a compelling treatment outcome tool. This preliminary evidence of its validity as a treatment outcome measure makes it applicable in other research settings and suggests its potential use in clinical settings. Copyright © 2010 Elsevier B.V. All rights reserved.
-
accuracy of brief and full forms of the child Mania Rating Scale
Journal of Clinical Psychology, 2008Co-Authors: David B Henry, Eric A. Youngstrom, Mani N Pavuluri, Boris BirmaherAbstract:This study assesses the sensitivity of full and brief forms of a parent-rated Mania Scale to variations in diagnoses. Parents of a sample of 150 subjects either diagnosed with bipolar disorder (BD) or attention deficit hyperactivity disorder (ADHD), or healthy controls (HC), completed the full Child Mania Rating Scale and other measures. We used single-parameter item-response theory models to produce a brief parent Mania Rating Scale from the full version. The 10-item, brief Child Mania Rating Scale—Parent (CMRS-P) version correlated .93 with 11 items from the full CMRS-P that were not used in constructing the brief version, and showed accuracy comparable to the full Scale in differentiating BD from ADHD, and in discriminating among bipolar subtypes. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64:1–14, 2008.
-
child Mania Rating Scale development reliability and validity
Journal of the American Academy of Child and Adolescent Psychiatry, 2006Co-Authors: Mani N Pavuluri, David Henry, Bhargavi Devineni, Julie A Carbray, Boris BirmaherAbstract:ABSTRACT Objective To develop a reliable and valid parent-report screening instrument for Mania, based on DSM-IV symptoms. Method A 21-item Child Mania Rating Scale-Parent version (CMRS-P) was completed by parents of 150 children (42.3% female) ages 10.3 ± 2.9 years (healthy controls=50; bipolar disorder=50; attention-deficit/hyperactivity disorder [ADHD] = 50). The Washington University Schedule for Affective Disorders and Schizophrenia was used to determine DSM-IV diagnosis. The Young Mania Rating Scale, Schedule for Affective Disorders and Schizophrenia Mania Rating Scale, Child Behavior Checklist, and Child Depression Inventory were completed to estimate the construct validity of the measure. Results Exploratory and confirmatory factor analysis of the CMRS-P indicated that the Scale was unidimensional. The internal consistency and retest reliability were both 0.96. Convergence of the CMRS-P with the Washington University Schedule for Affective Disorders and Schizophrenia Mania module, the Schedule for Affective Disorders and Schizophrenia Mania Rating Scale, and the Young Mania Rating Scale was excellent (.78-.83). The Scale did not correlate as strongly with the Conners parent-rated ADHD Scale, the Child Behavior Checklist -Attention Problems and Aggressive Behavior subScales, or the child self-report Child Depression Inventory (.29-.51). Criterion validity was demonstrated in analysis of receiver opeRating characteristics curves, which showed excellent sensitivity and specificity in differentiating children with Mania from either healthy controls or children with ADHD (areas under the curve of.91 to.96). Conclusion The CMRS-P is a promising parent-report Scale that can be used in screening for pediatric Mania.