Sabeen Rizvi | University of Delhi (original) (raw)

Papers by Sabeen Rizvi

European Child & Adolescent Psychiatry, 2018

We compared the diagnostic efficiency of the Child Behavior Checklist (CBCL) Thought Problems sub... more We compared the diagnostic efficiency of the Child Behavior Checklist (CBCL) Thought Problems subscale and the rationally derived DSM-oriented psychotic symptoms scale (DOPSS) to identify clinically concerning psychosis in a multi-site sample of youths seeking outpatient mental health services (N = 694). We operationally defined clinically concerning psychosis as the presence of clinically significant hallucinations or delusions, assessed by the Schedule for Affective Disorders and Schizophrenia psychosis items. Both the Thought Problems and DOPSS scores showed significant areas under the curve (AUCs = 0.65 and 0.70, respectively), but the briefer DOPSS showed statistically significantly better diagnostic efficiency for any clinically concerning psychosis, but the difference was small enough that it would not be clinically meaningful. The optimal psychosis screening cutoff score (maximizing sensitivity and specificity) was 68.5+ [corresponding diagnostic likelihood ratio (DiLR) = 1.59] for the Thought Problems subscale and 1.67+ (DiLR = 1.97) for the DOPSS. Both the CBCL Thought Problems and DOPSS are clinically useful for identifying psychotic symptoms in children, and although the DOPSS showed statistically better discriminating power, the difference was small so we would not necessarily recommend the DOPSS over standard scoring.

Psychological Bulletin, 2018

Shifting definitions and differences in the conceptualization of bipolar disorders have contribut... more Shifting definitions and differences in the conceptualization of bipolar disorders have contributed to long diagnostic delays, poor reliability, and inconsistent findings. Rating scales are independent of clinical judgment and offer a reliable way to assess manic symptoms, making them good tools to improve both clinical and research diagnoses of bipolar disorder. However, there are dozens of candidates, with few obvious distinguishing characteristics, making it difficult to select one. Our goal was to metaanalyze the diagnostic accuracy of rating scales designed to identify [hypo]manic symptoms. Additionally, we explored potential moderator variables including global region, translation into a different language, and sample composition. Nearly 4000 articles were identified with searches in PubMed and PsycINFO, yielding 127 effect sizes from 103 studies that met the following inclusion criteria: (a) statistics reported by which a standardized effect size could be calculated, (b) participants age 18 + years, (c) reference diagnoses made by semistructured/structured diagnostic interview, (d) results published in English. Multivariate mixed regression models accounted for multiple effect sizes nested within sample. One hundred twenty-seven effect sizes across 14 rating scales were evaluated. There was significant heterogeneity across effect sizes; Cochran’s Q(126 df) = 1622.08, p < .00005, and substantial variance components both within (&sgr;2 = .057) and between samples (&sgr;2 = .253). Four measures performed similarly well and significantly better than some competitors after controlling for design and reporting features. The best rating scales offer an inexpensive, efficient way to improve research and clinical diagnostic processes across diverse populations, and could also complement formal diagnoses for examining secular and cultural trends.

Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, Jan 26, 2018

Diagnostic accuracy of the Diagnostic and Statistical Manual of Mental Disorders-oriented Child a... more Diagnostic accuracy of the Diagnostic and Statistical Manual of Mental Disorders-oriented Child and Adolescent Symptom Inventory (CASI-4R) Psychotic Symptoms scale was tested using receiver operating characteristic analyses to identify clinically significant psychotic symptoms. Participants were new outpatients (N = 700), ages 6.0 to 12.9 years (M = 9.7, SD = 1.8) at 9 child outpatient mental health clinics, who participated in the Longitudinal Assessment of Manic Symptoms (LAMS) Study baseline assessment. Because LAMS undersampled participants with low mania scores by design, present analyses weighted low scorers to produce unbiased estimates. Psychotic symptoms, operationally defined as a score of 3 or more for hallucinations or 4 or more for delusions based on the Schedule for Affective Disorders and Schizophrenia (K-SADS) psychosis items, occurred in 7% of youth. K-SADS diagnoses for those identified with psychotic symptoms above threshold included major depressive disorder, bip...

Clinical Practice, 2014

Practice points • Despite converging evidence validating pediatric bipolar disorder (PBD), it is ... more Practice points • Despite converging evidence validating pediatric bipolar disorder (PBD), it is still challenging to diagnose PBD accurately. • Consideration of the developmental course and common comorbidities will help improve the diagnostic accuracy of PBD. • Clinical triggers such as family history, early-onset depression, antidepressant-coincident mania, episodic mood lability, episodic aggressive behavior, psychotic features and sleep disturbance should trigger a thorough evaluation of possible PBD. • Semistructured interviews remain the gold standard for assessing for PBD. • Understanding cultural dynamics such as training, class/race issues, stigma and lifestylerelated factors may help bridge the gap between research and practice. Converging evidence from both community and clinical settings shows that pediatric bipolar disorder is a valid diagnosis and a debilitating condition. While the field has evolved considerably, there remain gaps in diagnosis, assessment, research and practice. This article critically appraises: advances in understanding of the phenomenology of pediatric bipolar disorder; changes in diagnostic criteria from the Diagnostic and Statistical Manual (DSM)-IV to DSM-5 and corresponding controversies; the epidemiology of pediatric bipolar disorder; current assessment and diagnostic practices; and cultural factors influencing treatment seeking and diagnosis. We recommend using an evidence-based framework for bridging the gap between research and clinical practice.

European Child & Adolescent Psychiatry, 2018

We compared the diagnostic efficiency of the Child Behavior Checklist (CBCL) Thought Problems sub... more We compared the diagnostic efficiency of the Child Behavior Checklist (CBCL) Thought Problems subscale and the rationally derived DSM-oriented psychotic symptoms scale (DOPSS) to identify clinically concerning psychosis in a multi-site sample of youths seeking outpatient mental health services (N = 694). We operationally defined clinically concerning psychosis as the presence of clinically significant hallucinations or delusions, assessed by the Schedule for Affective Disorders and Schizophrenia psychosis items. Both the Thought Problems and DOPSS scores showed significant areas under the curve (AUCs = 0.65 and 0.70, respectively), but the briefer DOPSS showed statistically significantly better diagnostic efficiency for any clinically concerning psychosis, but the difference was small enough that it would not be clinically meaningful. The optimal psychosis screening cutoff score (maximizing sensitivity and specificity) was 68.5+ [corresponding diagnostic likelihood ratio (DiLR) = 1.59] for the Thought Problems subscale and 1.67+ (DiLR = 1.97) for the DOPSS. Both the CBCL Thought Problems and DOPSS are clinically useful for identifying psychotic symptoms in children, and although the DOPSS showed statistically better discriminating power, the difference was small so we would not necessarily recommend the DOPSS over standard scoring.

Psychological Bulletin, 2018

Shifting definitions and differences in the conceptualization of bipolar disorders have contribut... more Shifting definitions and differences in the conceptualization of bipolar disorders have contributed to long diagnostic delays, poor reliability, and inconsistent findings. Rating scales are independent of clinical judgment and offer a reliable way to assess manic symptoms, making them good tools to improve both clinical and research diagnoses of bipolar disorder. However, there are dozens of candidates, with few obvious distinguishing characteristics, making it difficult to select one. Our goal was to metaanalyze the diagnostic accuracy of rating scales designed to identify [hypo]manic symptoms. Additionally, we explored potential moderator variables including global region, translation into a different language, and sample composition. Nearly 4000 articles were identified with searches in PubMed and PsycINFO, yielding 127 effect sizes from 103 studies that met the following inclusion criteria: (a) statistics reported by which a standardized effect size could be calculated, (b) participants age 18 + years, (c) reference diagnoses made by semistructured/structured diagnostic interview, (d) results published in English. Multivariate mixed regression models accounted for multiple effect sizes nested within sample. One hundred twenty-seven effect sizes across 14 rating scales were evaluated. There was significant heterogeneity across effect sizes; Cochran’s Q(126 df) = 1622.08, p < .00005, and substantial variance components both within (&sgr;2 = .057) and between samples (&sgr;2 = .253). Four measures performed similarly well and significantly better than some competitors after controlling for design and reporting features. The best rating scales offer an inexpensive, efficient way to improve research and clinical diagnostic processes across diverse populations, and could also complement formal diagnoses for examining secular and cultural trends.

Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, Jan 26, 2018

Diagnostic accuracy of the Diagnostic and Statistical Manual of Mental Disorders-oriented Child a... more Diagnostic accuracy of the Diagnostic and Statistical Manual of Mental Disorders-oriented Child and Adolescent Symptom Inventory (CASI-4R) Psychotic Symptoms scale was tested using receiver operating characteristic analyses to identify clinically significant psychotic symptoms. Participants were new outpatients (N = 700), ages 6.0 to 12.9 years (M = 9.7, SD = 1.8) at 9 child outpatient mental health clinics, who participated in the Longitudinal Assessment of Manic Symptoms (LAMS) Study baseline assessment. Because LAMS undersampled participants with low mania scores by design, present analyses weighted low scorers to produce unbiased estimates. Psychotic symptoms, operationally defined as a score of 3 or more for hallucinations or 4 or more for delusions based on the Schedule for Affective Disorders and Schizophrenia (K-SADS) psychosis items, occurred in 7% of youth. K-SADS diagnoses for those identified with psychotic symptoms above threshold included major depressive disorder, bip...

Clinical Practice, 2014

Practice points • Despite converging evidence validating pediatric bipolar disorder (PBD), it is ... more Practice points • Despite converging evidence validating pediatric bipolar disorder (PBD), it is still challenging to diagnose PBD accurately. • Consideration of the developmental course and common comorbidities will help improve the diagnostic accuracy of PBD. • Clinical triggers such as family history, early-onset depression, antidepressant-coincident mania, episodic mood lability, episodic aggressive behavior, psychotic features and sleep disturbance should trigger a thorough evaluation of possible PBD. • Semistructured interviews remain the gold standard for assessing for PBD. • Understanding cultural dynamics such as training, class/race issues, stigma and lifestylerelated factors may help bridge the gap between research and practice. Converging evidence from both community and clinical settings shows that pediatric bipolar disorder is a valid diagnosis and a debilitating condition. While the field has evolved considerably, there remain gaps in diagnosis, assessment, research and practice. This article critically appraises: advances in understanding of the phenomenology of pediatric bipolar disorder; changes in diagnostic criteria from the Diagnostic and Statistical Manual (DSM)-IV to DSM-5 and corresponding controversies; the epidemiology of pediatric bipolar disorder; current assessment and diagnostic practices; and cultural factors influencing treatment seeking and diagnosis. We recommend using an evidence-based framework for bridging the gap between research and clinical practice.