All interviews for the RAP and AMDS studies were administered by a trained masters- or doctoral-level psychologist (RAP) and/or medical doctor (AMDS). Axis I diagnoses were assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I/CV) (78 ), with added components from the Kiddie-Schedule for Affective Disorders and Schizophrenia (79 (link)) for childhood disorders not contained in the SCID (e.g., oppositional defiant disorder, conduct disorder, autism spectrum disorders), interviewing both the patient and the caregiver separately, integrating the results from the two separate interviews.
The BPSS-P (Correll CU, Auther AM, Cornblatt BA. The Bipolar Prodrome Symptom Interview and Scale–Prospective, unpublished manual.) is a semi-structured interview that was developed based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (38 ) criteria for BD and MDD, as well as established rating scales for mania, depression and other psychopathology. In addition, the BPSS-P development was informed by a review of existing literature regarding risk factors and early symptoms of BD (1 (link)), published scales and interviews for the assessment of the psychotic prodrome and character traits, input from experts in the areas of the schizophrenia prodrome and BD, and open questioning of youth with BD and their caregivers regarding emerging subthreshold symptoms prior to the onset of a first syndromal bipolar manic, mixed and major depressive episode. Finally, the identified items were used to develop the semi-structured Bipolar Prodrome Symptom Interview and Scale–Retrospective (BPSS-R) (25 (link)). The use of the BPSS-R in clinical samples of youth and young adults with established BD-I and BD-II further informed the final BPSS-P development.
The BPSS-P assesses the onset and severity of prodromal symptoms and is divided into three sections: Mania, Depression, and General Symptom Index (seeAppendix A ). The format of the BPSS-P was modeled after the Scale of Prodromal Symptoms (SOPS) (74 (link)), such that each symptom is rated on the following ordinal scale: 0 = absent, 1 = questionably present, 2 = mild, 3 = moderate, 4 = moderately severe, 5 = severe, and 6 = extreme. Each symptom is assessed by specific probes and anchors for accurate ratings. The severity of the symptoms is assessed for the past month and the past year. Administration of the BPSS-P takes about one hour in HCs and 1.5–2.5 hours in psychiatric patients or their caregivers, depending on the extent and severity of past and current psychopathology.
To test inter-rater reliability, four raters/interviewers at the Masters (n = 1: SS), Ph.D. psychology (n = 2: AMA, MH), or medical doctor level (n = 1: TK) rated six reliability video tapes of a patient interview conducted by one of the four expert interviewers (one interview only contained the ten BPSS-P mania items plus mood lability, a general psychopathology item). These four raters had been trained on the BPSS-P, using three training videos and had at least two years (range: 2–6 years) of BPSS-P interview and rating experience.
The YMRS (80 (link)) was used to measure interviewer-rated manic symptoms. The Montgomery–Åsberg Rating Scale (MADRS) (81 (link)), which was administered in a subgroup of the AMDS sample (n = 61), was used to measure interviewer-rated depressive symptoms. The General Behavior Inventory-10-item Mania Form (GBI-M-10) (62 (link)) parent and respective patient self-report, which was added later to the assessment battery of the AMDS sample (n = 31), was used to measure self-reported mania-like symptoms. Temperament was measured with the Cyclothymic–Hypersensitive Temperament questionnaire (CHT) (82 (link)) of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego–Autoquestionnaire (TEMPS-A) (83 (link)).
The BPSS-P (Correll CU, Auther AM, Cornblatt BA. The Bipolar Prodrome Symptom Interview and Scale–Prospective, unpublished manual.) is a semi-structured interview that was developed based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (38 ) criteria for BD and MDD, as well as established rating scales for mania, depression and other psychopathology. In addition, the BPSS-P development was informed by a review of existing literature regarding risk factors and early symptoms of BD (1 (link)), published scales and interviews for the assessment of the psychotic prodrome and character traits, input from experts in the areas of the schizophrenia prodrome and BD, and open questioning of youth with BD and their caregivers regarding emerging subthreshold symptoms prior to the onset of a first syndromal bipolar manic, mixed and major depressive episode. Finally, the identified items were used to develop the semi-structured Bipolar Prodrome Symptom Interview and Scale–Retrospective (BPSS-R) (25 (link)). The use of the BPSS-R in clinical samples of youth and young adults with established BD-I and BD-II further informed the final BPSS-P development.
The BPSS-P assesses the onset and severity of prodromal symptoms and is divided into three sections: Mania, Depression, and General Symptom Index (see
To test inter-rater reliability, four raters/interviewers at the Masters (n = 1: SS), Ph.D. psychology (n = 2: AMA, MH), or medical doctor level (n = 1: TK) rated six reliability video tapes of a patient interview conducted by one of the four expert interviewers (one interview only contained the ten BPSS-P mania items plus mood lability, a general psychopathology item). These four raters had been trained on the BPSS-P, using three training videos and had at least two years (range: 2–6 years) of BPSS-P interview and rating experience.
The YMRS (80 (link)) was used to measure interviewer-rated manic symptoms. The Montgomery–Åsberg Rating Scale (MADRS) (81 (link)), which was administered in a subgroup of the AMDS sample (n = 61), was used to measure interviewer-rated depressive symptoms. The General Behavior Inventory-10-item Mania Form (GBI-M-10) (62 (link)) parent and respective patient self-report, which was added later to the assessment battery of the AMDS sample (n = 31), was used to measure self-reported mania-like symptoms. Temperament was measured with the Cyclothymic–Hypersensitive Temperament questionnaire (CHT) (82 (link)) of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego–Autoquestionnaire (TEMPS-A) (83 (link)).
