Youngstrom Eric A, Gracious Barbara L, Danielson Carla K, Findling Robert L, Calabrese Joseph
Department of Psychiatry at Case Western Reserve University & University Hospitals of Cleveland, Cleveland, OH, USA.
J Affect Disord. 2003 Nov;77(2):179-90. doi: 10.1016/s0165-0327(02)00108-8.
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.
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.
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.
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.
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.
青年躁狂评定量表（YMRS）在评估成人躁狂方面具有效度。本研究的目的是探讨YMRS如何能最优化地用于评估青少年。
5至17岁的儿童和青少年参与了本研究。所有青少年均接受了学龄儿童情感障碍和精神分裂症量表（K-SADS）的评估。根据K-SADS的结果，受试者随后被分配到五个组之一：双相I型组、另一个双相谱系组、抑郁障碍组、破坏性行为障碍组和无诊断组。监护人完成了一份为家长报告修改后的YMRS版本。临床医生对所有参与研究的青少年完成了YMRS评估。
YMRS上家长和临床医生的评分将患者（n = 117）分配到适当诊断组的准确率为71%-98%。整合来自多个信息提供者的信息并没有显著改善诊断组的分配。
相同的评估者完成了临床医生的YMRS以及涉及家长的K-SADS访谈。研究结果需要在一个双相情感障碍基础率更低、评估者训练和监督不够严格、采用前瞻性设计以提供结果最大可推广性的独立样本中进行重复验证。当前结果应被解释为一种“最佳情况”。
这些数据表明YMRS可能是评估青少年躁狂严重程度的有用辅助工具。提出了初步的划界分数以最大化效率、敏感性和特异性。
