Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study.
Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study.
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DOI：
10.1111/j.1399-5618.2009.00686.x
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发表时间：
2009-06
影响因子：
5.4
通讯作者：
Sachs G
中科院分区：
文献类型：
--
作者：
Perlis RH;Dennehy EB;Miklowitz DJ;Delbello MP;Ostacher M;Calabrese JR;Ametrano RM;Wisniewski SR;Bowden CL;Thase ME;Nierenberg AA;Sachs G
双相情感障碍的症状在儿童和青少年中越来越多地被认识到，但对经历儿童期症状发作的成年人的双相情感障碍的病程知之甚少。我们对参加多中心临床有效性研究（双相障碍系统治疗增强计划（STEP-BD））的3，658名成人I型和II型双相门诊患者进行了长达两年的自然主义治疗的前瞻性结局进行了研究。通过临床医生在研究入组时的评估，回顾性确定疾病发作时的年龄。与18岁以后出现情绪症状的患者（n = 1，187）相比，13岁以前出现情绪症状的患者（n = 1，068）在最初缓解后更早复发情绪发作，心境正常的天数更少，在两年的随访中功能和生活质量受损更大。发病年龄在13 - 18岁之间的患者（n = 1，403）的结局通常介于这两组之间。与先前在较小队列中的报告一致，回顾性获得的早发性双相情感障碍成人患者在前瞻性观察期间复发、情绪症状慢性化和功能损害的风险似乎更大。
Symptoms of bipolar disorder are increasingly recognized among children and adolescents, but little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms. We examined prospective outcomes during up to two years of naturalistic treatment among 3,658 adult bipolar I and II outpatients participating in a multicenter clinical effectiveness study, the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Age at illness onset was identified retrospectively by clinician assessment at study entry. Compared to patients with onset of mood symptoms after age 18 years (n = 1,187), those with onset before age 13 years (n = 1,068) experienced earlier recurrence of mood episodes after initial remission, fewer days of euthymia, and greater impairment in functioning and quality of life over the two-year follow-up. Outcomes for those with onset between age 13 and 18 years (n = 1,403) were generally intermediate between these two groups. Consistent with previous reports in smaller cohorts, adults with retrospectively obtained early-onset bipolar disorder appear to be at greater risk for recurrence, chronicity of mood symptoms, and functional impairment during prospective observation.
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影响因子：
5.3
作者：
Goldberg, JF;Ernst, CL
通讯作者：
Ernst, CL
影响因子：
5.1
作者：
Leverich, Gabriele S.;Post, Robert M.;Luckenbaugh, David
通讯作者：
Luckenbaugh, David
影响因子：
--
作者：
Judd, LL;Akiskal, HS;Keller, MB
通讯作者：
Keller, MB
影响因子：
17.7
作者：
Geller, B;Craney, JL;Zimerman, B
通讯作者：
Zimerman, B
影响因子：
1.9
作者：
KELLER, MB;LAVORI, PW;MUELLER, TI
通讯作者：
MUELLER, TI