A consecutive series of treated affected offspring of parents with bipolar disorder: Is response associated with the clinical profile?
A consecutive series of treated affected offspring of parents with bipolar disorder: Is response associated with the clinical profile?
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DOI：
10.1177/070674370705200606
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发表时间：
2007-06-01
影响因子：
4
通讯作者：
Grof, Paul
中科院分区：
文献类型：
--
作者：
Duffy, Anne;Alda, Martin;Grof, Paul
目的：在患有双相情感障碍（BD）的成年人中，对情绪稳定剂的不同反应与临床特征相关。缺乏针对患有双相情感障碍的青少年的长期治疗研究。本文提供了青少年双相情感障碍患者病程早期对情绪稳定剂反应的纵向观察。方法：我们报告了 15 名青少年研究患者，这些患者在青少年时期符合 DSM-IV 中双相谱系障碍的终生标准，需要长期治疗。这些青少年来自父母之一患有双相情感障碍的家庭，其病程和长期治疗反应是根据研究标准确定的。向患者提供锂盐，如果他们没有反应或拒绝，则接受抗惊厥药或非典型抗精神病药治疗。使用经过验证的量表，独立评估者对长期治疗的反应进行回顾性盲法评分。结果：那些对锂药物治疗稳定的患者来自对锂盐反应的家庭，而那些对锂药物治疗稳定的患者来自对锂盐无反应的家庭。通过锂盐稳定的青少年的临床病程与通过非典型抗精神病药稳定的青少年的临床病程不同。结论：我们的研究结果表明，临床特征可能有助于选择有效的稳定治疗，并且一部分青少年可以通过单一疗法稳定病情。这是一个小病例系列，治疗分配非随机，研究结果应被视为暂时性的。
Objective: In adults with established bipolar disorder (BD), differential response to mood stabilizers has been associated with the clinical profile. Long-term treatment studies of youth with BD are lacking. This paper provides longitudinal observations of response to mood stabilizers early in the course of illness in youth with BD.Method: We report on 15 research patients who, as adolescents, met DSM-IV lifetime criteria for a bipolar spectrum disorder and required long-term treatment. These youths derived from families with one parent having BD whose course and long-term treatment response were determined in accordance with research criteria. The patients were offered lithium, and if they failed to respond or refused it, they were treated with either an anticonvulsant or an atypical antipsychotic. Using a validated scale, an independent rater retrospectively blindly scored the response to long-term treatment.Results: Those patients who stabilized on lithium derived from lithium-responsive families, whereas those who stabilized on an antipsychotic derived from lithium-nonresponsive families. The clinical course in the youths stabilized by lithium differed from that in the youths stabilized by an atypical antipsychotic.Conclusions: Our findings suggest that the clinical profile may help in selecting effective stabilizing treatment and that a proportion of youth can be stabilized on monotherapy. This is a small case series with nonrandom treatment assignment, and the findings should be considered tentative.