National trends in the outpatient diagnosis and treatment of bipolar disorder in youth
National trends in the outpatient diagnosis and treatment of bipolar disorder in youth
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DOI：
10.1001/archpsyc.64.9.1032
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发表时间：
2007-09-01
影响因子：
--
通讯作者：
Olfson, Mark
中科院分区：
文献类型：
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作者：
Moreno, Carmen;Laje, Gonzalo;Olfson, Mark
内容：虽然双相情感障碍可能在儿童期发病，但对年轻人双相情感障碍的诊断和管理的国家趋势知之甚少。目的：介绍诊断为双相情感障碍的门诊就诊的国家趋势，并比较在这些就诊期间提供给青年和成人的治疗。设计：我们比较了1994 - 1995年和2002-2003年诊断为双相情感障碍的0 - 19岁个体与20岁或20岁以上个体的就诊增长率。从1999年到2003年，我们还比较了青少年和成人双相情感障碍就诊的人口统计学、临床和治疗特征。设置：门诊就诊的医生以办公室为基础的做法。参与者：来自全国门诊医疗保健调查的患者（1999-2003年），诊断为双相情感障碍的患者（n=962）。主要结果测量：（0-19岁）和成人（年龄>= 20岁）。估计每年诊断为双相情感障碍的青年办公室访问人数从25人增加到25人，（1994-1995年）到1003（2002-2003年）每100 000人就诊，在此期间，诊断为双相情感障碍的成人就诊从905人增加到1 679人。1999年至2003年，大多数青少年双相情感障碍患者为男性（66.5%），而大多数成年双相情感障碍患者为女性（67.6%）;青少年比成年人更容易接受注意力缺陷/多动障碍的共病诊断（分别为32.2%和3.0%; P
Context: Although bipolar disorder may have its onset during childhood, little is known about national trends in the diagnosis and management of bipolar disorder in young people.Objectives: To present national trends in outpatient visits with a diagnosis of bipolar disorder and to compare the treatment provided to youth and adults during those visits.Design: We compare rates of growth between 19941995 and 2002-2003 in visits with a bipolar disorder diagnosis by individuals aged 0 to 19 years vs those aged 20 years or older. For the period of 1999 to 2003, we also compare demographic, clinical, and treatment characteristics of youth and adult bipolar disorder visits.Setting: Outpatient visits to physicians in office-based practice.Participants: Patient visits from the National Ambulatory Medical Care Survey (1999-2003) with a bipolar disorder diagnosis (n=962).Main Outcome Measures: Visits with a diagnosis of bipolar disorder by youth ( aged 0-19 years) and by adults (aged >= 20 years).Results: The estimated annual number of youth office-based visits with a diagnosis of bipolar disorder increased from 25 (1994-1995) to 1003 (2002-2003) visits per 100 000 population, and adult visits with a diagnosis of bipolar disorder increased from 905 to 1679 visits per 100 000 population during this period. In 1999 to 2003, most youth bipolar disorder visits were by males (66.5%), whereas most adult bipolar disorder visits were by females (67.6%); youth were more likely than adults to receive a comorbid diagnosis of attention-deficit/hyperactivity disorder (32.2% vs 3.0%, respectively; P