How cardinal are cardinal symptoms in pediatric bipolar disorder? An examination of clinical correlates
How cardinal are cardinal symptoms in pediatric bipolar disorder? An examination of clinical correlates
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DOI：
10.1016/j.biopsych.2005.08.014
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发表时间：
2005-10-01
影响因子：
10.6
通讯作者：
van Grondelle, A
中科院分区：
文献类型：
--
作者：
Wozniak, J;Biederman, J;van Grondelle, A
背景：本研究的主要目的是检验假设的欣快感主要症状是否会导致双相青年在没有先验假设的情况下确定的临床相关因素的差异。方法：86例符合DSM-IV双相情感障碍标准的患者（n = 86），有或没有提出的欣快主要症状，比较他们的双相情感障碍症状模式、功能和合并症模式。结果：在A标准（异常情绪）中，我们发现严重易怒是主要的异常情绪，而不是欣快感（94%对51%）。我们还发现，在标准B项中，狂妄不是唯一在躁狂症青年中被过度代表的，狂妄的比率也没有区别，无论是易怒还是易怒和欣快是标准A的情绪症状。合并症的症状描述模式和功能测量都与欣快感的存在与否无关。结论：这些发现挑战了“欣快感是儿童躁狂的主要症状”的观念。相反，他们支持严重易怒是年轻人最常见的躁狂症表现的临床相关性。他们还支持在儿科人群中使用未修改的DSM-IV标准来建立躁狂症的诊断。
Background: The main goal of this study was to test whether the hypothesized cardinal symptom of euphoria results in differences in clinical correlates in bipolar youth ascertained with no a priori assumptions about cardinal symptoms.Methods: Subjects (n = 86) satisfying DSM-IV criteria,for bipolar disorder with and without the proposed cardinal symptom of euphoria were compared in their bipolar symptom pattern, functioning and patterns of comorbidity.Results: Among Criterion A (abnormal mood), we found that severe irritability was the predominant abnormal mood rather than euphoria (94% vs. 51%). We also found that among Criterion B items, grandiosity was not uniquely over represented in youth with mania, nor did the rate of grandiosity differ whether irritability or irritability and euphoria were the Criterion A mood symptom. Neither symptom profiled patterns of comorbidity nor measures of functioning differed related to the presence or absence of euphoria.Conclusions: These findings challenge the notion that euphoria represents a cardinal symptom of mania in children. Instead they support the clinical relevance of severe irritability as the most common presentation of mania in the young. They also support the use of unmodified DSM-IV criteria in establishing the diagnosis of mania in pediatric populations.