Clinical Tools

The Child and Adolescent Bipolar Spectrum Services (CABS) Clinic strives to educate professionals in the diagnosis and treatment of Bipolar Disorder as well as to provide helpful information to families.  We provide access to diagnostic instruments, psychoeducational materials and comprehensive training in the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) diagnostic tool.  

Risk Calculator

Risk Calculator to evaluate the risk for recurrence in Youths with Bipolar Disorder

  • This risk calculator estimates the risk to have a mood recurrence (mania and/or depression) in patients who currently are in remission (about 2 months being symptom free or having minimal mood symptoms).  It includes items from the literature that have shown to predict mood recurrences.  In addition to the clinical information indicated, the maximum severity of the most recent manic/hypomanic and depressive episode needs to be calculated using the Psychiatric Rating Scale modified from the Longitudinal Interval Follow-up Evaluation (LIFE) using a modified version of this instrument.  These values and the other clinical information need to be entered into the calculator to obtain the risk score. The risk scores produced by the risk calculator will predict the risk of a mood recurrence by polarity in the next five years.
     
  • Click here for the RISK CALCULATOR

Risk Calculators to evaluate the risk to develop Bipolar Spectrum Disorders

  • This risk calculator estimates the five-year risk of developing new-onset bipolar disorder in 8–17-year-old children who have a parent with bipolar disorder. It includes items from a previous meta-analysis of the literature that have been shown to predict bipolar disorder onset. Instruments should only be administered by trained interviewers. (Hafeman, D. M., et al. "Assessment of a Person-Level Risk Calculator to Predict New-Onset Bipolar Spectrum Disorder in Youth at Familial Risk." JAMA Psychiatry, 2017.)
     
  • Click here for the RISK CALCULATOR.

Risk Calculator to evaluate the risk of conversion from subsyndromal mania (BP-Not Otherwise Specified) to BP-I/II

  • This risk calculator estimates the conversion from bipolar disorder - NOS to bipolar I or bipolar II disorder in 8-17 year old children who have a parent with bipolar disorder. It includes items from the literature that have been shown to predict bipolar disorder onset. Instruments should only be administered by trained interviewers. (Birmaher, B., et al. "A Risk Calculator to Predict the Individual Risk of Conversion from Bipolar Not Otherwise Specified to Bipolar Disorder I or II in Youth." under review)
     
  • Click here for RISK CALCULATOR

DISCLAIMER:  This Risk Calculator is being provided by the University of Pittsburgh for use by clinicians for educational purposes only. The Calculator is not intended to diagnose patients or be used as a substitute for medical advice. The University makes no warranty concerning the accuracy or reliability of the information generated by the Calculator. In no event shall the University of Pittsburgh be liable for any damages, direct, indirect, consequential or otherwise related to the use of the information on this website or results generated by the Calculator. Patients should contact their health care provider for medical advice or, in the case of an emergency, go to the nearest emergency room.

Instruments

Screen for Child Anxiety Related Emotional Disorders (SCARED)

The SCARED is a child and parent self-report instrument used to screen for childhood anxiety disorders including general anxiety disorder, separation anxiety disorder, panic disorder and social phobia. In addition, it assesses symptoms related to school phobia. The SCARED consists of 41 items and 5 factors that parallel the DSM-IV classification of anxiety disorders. The child and parent versions of the SCARED have moderate parent-child agreement and good internal consistency, test-retest reliability, and discriminant validity, and it is sensitive to treatment response.  Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–6.

  • Target population: Children ages 8-18 years
  • Intended users: Clinicians and Psychiatrists
  • Time to Administer: 10 minutes
  • Completed by: Children and Parents
  • *For automated scoring, please download the document and enable editing.

For more information, please call Dr. Birmaher at (412) 246-5235 or via Email.

Pen and Paper Versions with Scoring Directions Attached
Automated Scoring for PCs 
Automated Scoring for MACs
Translations
Key Publications 

Screen for Adult Anxiety Related Disorders (SCAARED)

The (SCAARED) is an easy to administer 44-item self-report instrument used to screen for DSM-IV and 5 anxiety disorders including general anxiety disorder, separation anxiety disorder, panic disorder and social phobia in adults.  The SCAARED was derived from the SCARED for children to continue to evaluate the course of anxiety using a comparable anxiety instrument when children and adolescents become older than 18 years old. In addition, the SCAARED was developed to evaluate parents and compare their anxiety symptoms to their children’s using an instrument with comparable anxiety symptoms and factors. The SCAARED has good internal consistency, test-retest reliability, and discriminant validity, and it is sensitive to treatment response. 

For more information, please contact Dr. Birmaher at 412-246-5235 or via email.

Pen and Paper Version
Translations
Key Publications

Angulo M, Rooks BT, Gill M, Goldstein T, Sakolsky D, Goldstein B, Monk K, Hickey MB, Diler RS, Hafeman D, Merranko J, Axelson D, Birmaher B.  Psychometrics of the screen for adult anxiety related disorders (SCAARED)- A new scale for the assessment of DSM-5 anxiety disorders.  Psychiatry Res.  2017 Feb17;253:84-90.  PMID:  28359032

Sanchez-Cueva S, Alonso-Esteban Y, Sanchez-Cueva P, Birmaher B, Alcantud-Marin F.  Psychometrics of the Spanish Version of the Screen for Adult Anxiety Related Disorders (SCAARED). Front Psychiatry. 2021 Feb 11;12:589422.  PMID:  33643088

K-SADS Mania Rating Scale

This rating scale is based on the items from the WASH-U-KSADS (Barbara Geller, M.D.) and the 4th Revision of the KSADS-P (Joaquim Puig-Antich, M.D. and Neal Ryan, M.D.). The following items are to determine the presence of mania or hypomania during a period of time prescribed by the rater/study. At the end of the scale, the rater should note the onset and offset of the time period being rated. If any of the items are judged present, inquire in a general way to determine how s/he was behaving at the time with such questions as, "When you were this way, what kind of things were you doing? How did you spend your time?" If there have been manic periods it is exceedingly important that they are clearly delineated. Whenever two or more items are scored positively, it is important to determine if they occurred at the same time.

K-SADS Mania Rating Scale and Comparative Scoring

K-SADS Depression Rating Scale

This rating scale is based on the items from the WASH-U-KSADS (Barbara Geller, M.D.) and the 4th Revision of the KSADS-P (Joaquim Puig-Antich, M.D. and Neal Ryan, M.D.). The following items are to determine the presence of depression during a period of time prescribed by the rater/study. At the end of the scale, the rater should note the onset and offset of the time period being rated. If any of the items are judged present, inquire in a general way to determine how s/he was behaving at the time with such questions as, "When you were this way, what kind of things were you doing? How did you spend your time?" If there have been periods of depression it is exceedingly important that they are clearly delineated. Whenever two or more items are scored positively, it is important to determine if they occurred at the same time.

K-SADS Depression Rating Scale and Comparative Scoring

K-SADS PL DSM-5 (November 2016)

Permitted Usage

Use is freely permitted without further permission for uses that meet one or more of the following: 

  • Clinical usage in a not-for-profit institution 
  • Usage in an IRB approved research protocol 

All other uses require written permission of the principal author, Dr. Joan Kaufman (email), including but not limited to the following: 

  • Redistribution of the instrument in printed, electronic or other forms 
  • Commercial use of the instrument 
  • Modification of the instrument 
K-SADS PL DSM-5 Clinical Tools

K-SADS PL DSM-5 (Spanish Version)

Permitted Usage
Use is freely permitted without further permission for uses that meet one or more of the following: 

  • Clinical usage in a not-for-profit institution 
  • Usage in an IRB approved research protocol 

All other uses require written permission of the principal authors, Dr. Joan Kaufman (email) and Dr. Francisco de la Peña, including but not limited to the following: 

  • Redistribution of the instrument in printed, electronic or other forms 
  • Commercial use of the instrument 
  • Modification of the instrument 
K-SADS PL DSM-5 Clinical Tools (Spanish Version)

Mood Energy Thermometer 

Mood & Energy Thermometer: This is an improved and practical way of monitoring complex mood cycles and daily schedule. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression or extreme mania or no depression), we considered to improve the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, we incorporated energy levels in the mood rating. The Mood and Energy Thermometer that we developed at Western Psychiatric Institute and Clinic (WPIC) (and have used in about 400 kids) rates mania and increased energy on a 1 to 10 scale and rates depression and tiredness on -1 to -10 scale and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent in depression and/mania such as -4 would mean “mild depression” and “mild tiredness” present in ≥50% of the time and -3 would mean “mild depression” and “mild tiredness” present in < 50% of the time. Our inclusion of measuring energy levels is consistent with the DSM 5, because energy level is now in DSM 5 as a main mood symptom criterion. Bipolar track patients (whether they have mania or depression, or mixed features) are rating their mood and energy levels every day on this scale and our master’s degree clinician meet with them on daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also prevent a future episode.

Mood Energy Thermometer