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J Am Acad Child Adolesc Psychiatry. 2008 Oct;47(10):1151-7. doi: 10.1097/CHI.0b013e3181825a68.

CBCL pediatric bipolar disorder profile and ADHD: comorbidity and quantitative trait loci analysis.

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Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior and David Geffen School of Medicine,



The pediatric bipolar disorder profile of the Child Behavior Checklist (CBCL-PBD), a parent-completed measure that avoids clinician ideological bias, has proven useful in differentiating patients with attention-deficit/hyperactivity disorder (ADHD). We used CBCL-PBD profiles to distinguish patterns of comorbidity and to search for quantitative trait loci in a genomewide scan in a sample of multiple affected ADHD sibling pairs.


A total of 540 ADHD subjects ages 5 to 18 years were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version and CBCL. Parents were assessed with the Schedule for Affective Disorders and Schizophrenia-Lifetime version supplemented by the Schedule for Affective Disorders and Schizophrenia for School-Age Children for disruptive behavioral disorders. Patterns of psychiatric comorbidity were contrasted based on the CBCL-PBD profile. A quantitative trait loci variance component analysis was used to identify potential genomic regions that may harbor susceptibility genes for the CBCL-PBD quantitative phenotype.


Bipolar spectrum disorders represented less than 2% of the overall sample. The CBCL-PBD classification was associated with increased generalized anxiety disorder (p =.001), oppositional defiant disorder (p =.008), conduct disorder (p =.003), and parental substance abuse (p =.005). A moderately significant linkage signal (multipoint maximum lod score = 2.5) was found on chromosome 2q.


The CBCL-PBD profile distinguishes a subset of ADHD patients with significant comorbidity. Linkage analysis of the CBCL-PBD phenotype suggests certain genomic regions that merit further investigation for genes predisposing to severe psychopathology.

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