Association of psychosis with suicidality in pediatric bipolar I, II and bipolar NOS patients.
Association of psychosis with suicidality in pediatric bipolar I, II and bipolar NOS patients.
复制标题
儿科双相 I、II 和双相 NOS 患者精神病与自杀的关联。
DOI：
10.1016/j.jad.2005.12.008
复制
发表时间：
2006
影响因子：
6.6
通讯作者：
Soares,JairC
中科院分区：
文献类型：
--
作者：
Caetano,SheilaC;Olvera,ReneL;Hunter,Kristina;Hatch,JohnP;Najt,Pablo;Bowden,Charles;Pliszka,Steven;Soares,JairC
儿童心境障碍患者的精神病性可能与自杀意念有关。双相情感障碍（BP）青少年自杀风险高。我们研究了是否有精神病的儿童BP患者比非精神病BP患者有更高的自杀倾向的患病率。根据先前在成人BP患者中的发现，我们预测，与非精神病性BP患者相比，有精神病性症状的儿童BP患者自杀倾向的患病率更高，终生精神病住院的发生率更高，当前总体功能评估量表（GAF）评分更差。（平均年龄±标准差=11.2±2.8岁，范围=8-17岁）有（n=17）或无（n=26）精神病症状的终生病史的患者。自杀倾向指标（死亡想法和自杀意念、计划和企图）、精神病诊断、精神病症状、精神病住院和GAF评分通过K-SADS-PL访谈进行评估。表示交叉与无精神病的BP患者相比，有精神病症状终身史的儿童BP患者更容易想到死亡（100% vs 69.2%，p=0.01）、自杀意念（94.1% vs 42.3%，p=0.001）和自杀计划（64.7% vs 15.4%，p=0.002）。精神病性BP患者的精神病性住院发生率高于非精神病性BP患者（82.4%对46.2%，p=0.018）。精神症状是儿童BP患者自杀的危险因素。
BACKGROUNDPsychosis in pediatric mood disorder patients may be related to suicidal ideation. Bipolar (BP) adolescents are at high risk of completed suicide. We examined whether pediatric BP patients with psychosis have a higher prevalence of suicidality than non-psychotic BP patients. Based on previous findings in adult BP patients, we predicted that pediatric BP patients with psychotic symptoms would have higher prevalence of suicidality, higher occurrence of lifetime psychiatric hospitalizations and worse current Global Assessment of Functioning Scale (GAF) scores compared to non-psychotic BP patients.METHODSWe studied 43 BP children and adolescents (mean age±S.D=11.2±2.8 y, range=8–17) who did (n=17) or did not have (n=26) a lifetime history of psychotic symptoms. Indicators of suicidality (thoughts of death and suicidal ideation, plans, and attempts), psychiatric diagnoses, psychotic symptoms, psychiatric hospitalizations and GAF scores were assessed with the K-SADS-PL interview.LIMITATIONSSmall sample size, cross-sectional study and exclusion of substance abuse comorbidity.RESULTSPediatric BP patients with a lifetime history of psychotic symptoms compared to BP patients without psychosis were more likely to have thoughts of death (100% versus 69.2%, p=0.01), suicidal ideation (94.1% versus 42.3%, p=0.001) and suicidal plans (64.7% versus 15.4%, p=0.002). Occurrence of psychiatric hospitalization was higher in psychotic BP patients compared to non-psychotic BP patients (82.4% versus 46.2%, p=0.018).CONCLUSIONSPsychotic symptoms in pediatric BP patients are associated with suicidal ideation and plans, and psychiatric hospitalizations. Psychotic symptoms are a risk factor for suicidality amongst pediatric BP patients.