The Child Bipolar Questionnaire

The Child Bipolar Questionnaire (CBQ) is a reliable and sensitive diagnostic indicator for early onset bipolar disorder.  It is simple to use and may be self-administered by the child’s primary caretaker or administered by a clinician.

Since 2003, JBRF has collected symptom information from close to 20,000 children diagnosed with, or at risk for, bipolar disorder.  This enormous database has made possible the line of research that has recently articulated the Fear of Harm (FOH) phenotype (click Fear of harm, a possible phenotype of pediatric bipolar disorder: A dimensional approach to diagnosis for genotyping psychiatric syndromes to learn about the FOH phenotype).

Collection of this database has been made possible by the use of the CBQ, a screening instrument designed by Demitri Papolos, M.D., Director of Research for JBRF.

The unique feature of this 65 question screening instrument is that it collects information not only on the symptoms of bipolar disorder, but for many other disorders considered co-morbid to bipolar disorder (mania, major depression, separation anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, oppositional defiant disorder, conduct disorder and attention deficit disorder). Further, it allows that information to be reported in degrees of severity rather than simply “present” or “absent”.

Each item must be rated on a scale based upon frequency of occurrence:

“1” for “never”

“2” for “sometimes”

“3” for “often”

“4” for “very often or almost constantly”

Statistical algorithms developed for the CBQ determine whether the responses indicate:

  1. a possible diagnosis of bipolar disorder as defined in DSM IV
  2. a possible diagnosis of bipolar disorder as defined in DSM IV with or without co-occurring ADHD
  3. a possible diagnosis ADHD with no mood disorder
  4. a possible diagnosis of Core phenotype.
  5. a possible diagnosis of Fear of Harm phenotype.

These algorithms have been tested and have demonstrated excellent validity and reliability. (click The child bipolar questionnaire- A dimensional approach to screening for pediatric bipolar disorder to read more about those tests).

The development of the CBQ is important as it provides an efficient screening tool that is both reliable and easy to use.  To date, K-SADS (Schedule for Affective Disorders and Schizophrenia for School Age Children) is the gold standard by which a diagnosis of bipolar disorder, ADHD and “no disorder” is made.  The K-SADS is expensive and time consuming to administer.  In contrast, the CBQ requires less than 20 minutes and may be completed without professional interaction.

In a study conducted to determine which algorithm was best able to predict a K-SADS finding of bipolar disorder, the Core phenotype algorithm not only demonstrated excellent reliability, but surpassed the predictive accuracy of the DSM IV algorithm.

Therefore, the Core phenotype is more likely to accurately determine if a child has bipolar disorder than can the DSM IV criteria.

Further, the CBQ can identify, with 96% accuracy, the presence of the recently defined FOH (Fear of Harm) phenotype which we believe represents a common and severe form of the bipolar condition.

The screening accuracy provided by the CBQ is sorely needed.  The lack of clear guidelines and the confusing presentation of this complex illness often result in misdiagnosis and the initiation of medication that can worsen its condition.  All the above notwithstanding, CBQ findings should be considered an addition to, rather than a substitute for, a well-considered professional evaluation.

JBRF uses the CBQ to determine potential eligibility for research studies and maintains email contact with the families who submit this data to inform them of their children’s initial eligibility.

A registration form must be filled out before parents may enter data using JBRF’s interactive data acquisition program.  This is a simple form that pops up before the CBQ can be accessed. Once the form is submitted, The Child Bipolar Questionnaire pops up. Data are stored using unique confidential parent and child ID numbers.  The registration form allows the registrant to choose to submit the CBQ data on an anonymous basis to JBRF’s database.

How do you know the results?

There are two options for obtaining the results of the CBQ:

At the completion of the questionnaire there is an option to print out the completed CBQ. Choose this option and bring the completed CBQ to the diagnosing or treating professional.

- OR -

Choose to purchase an automatically scored report.  The result is a printed score sheet for the CBQ listing important scores and their indications, as well as dimensions of impairment indicated by item responses.  This score sheet will be printed directly from the website.  The cost of this service is $25.00.*

* This fee-based service is offered by the private practice of Demitri Papolos, M.D., the JBRF Director of Research; this service is independent of the JBRF but may be accessed through the JBRF website.  Dr. Papolos developed the CBQ and the automated scoring report with the support of JBRF.  Questions and/or concerns with regard to the scored report should be addressed to jbrflistadmin@gmail.com.  

Please click here to take the CBQ

If you have already established an account, please click here to sign in and access your account.

If you are having difficulty accessing your score sheet, please click here to view Frequently Asked Questions.

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