Objective: To construct a mania rating scale designed for children and adolescents.
Methods: Fourteen questions from the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode (K-SADS-P) 1986 version plus a new item assessing mood lability were used to construct a clinician-rated mania rating scale (K-SADS-MRS). Interrater reliability was determined prospectively with 22 patients from a bipolar outpatient clinic. Sensitivity to treatment effects was determined in a separate cohort of 23 patients.
Results: Internal consistency (Cronbach's alpha = 0.94) and interrater reliability (intraclass correlation coefficient = 0.97 between two raters) were high. Convergent validity with the Clinical Global Impressions-Severity scale (bipolar version) was good (r(s)= 0.91, p < 0.001). Treatment responders had significantly greater reduction in K-SADS-MRS scores than nonresponders (-15.6 +/- 8.7 vs. 0.3 +/- 8.8), t(21) = 4.2, p < 0.001. The K-SADS-MRS scores differentiated bipolar patients who had clinically significant manic symptoms from those who did not, with a sensitivity of 87% and a specificity of 81%.
Conclusion: The K-SADS-MRS shows promise as a rating scale for measuring manic symptom severity in pediatric bipolar patients.