Since 2003, 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. This not only facilitates the collection of large amounts of data, but also provides a source for recruiting subjects. At this time, profiles that meet the FOH criteria are arriving at a rate of 8-10 per week. We are hopeful that this channel will provide the robust pools of homogeneous DNA that are needed for meaningful genetic evaluation. The recently completed Chronobiology Study, which identified the relationship between thermal dysregulation and circadian rhythm as a biomarker for the illness, recruited subjects from this channel.
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.