Parsing cyclothymic disorder and other specified bipolar spectrum disorders in youth.
Parsing cyclothymic disorder and other specified bipolar spectrum disorders in youth.
复制标题
解析青少年的循环性障碍和其他特定的双相谱系障碍。
DOI：
10.1016/j.jad.2018.06.023
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发表时间：
2018
影响因子：
6.6
通讯作者：
Birmaher,Boris
中科院分区：
文献类型：
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作者：
VanMeter,Anna;Goldstein,BenjaminI;Goldstein,TinaR;Yen,Shirley;Hower,Heather;Strober,Michael;Merranko,JohnA;Gill,MaryKay;Diler,RasimS;Axelson,David;Ryan,NealD;Keller,MartinB;Birmaher,Boris
目的：大多数关于儿童双相情感障碍（BP）的研究将有躁狂症状但不符合BP I/II标准的青少年合并为“未另行指定”（NOS）组。因此，对于患有循环胸腺障碍（CycD）的青年与患有BP NOS的青年之间的差异知之甚少。本研究的目的是确定研究诊断为CycD （RDCyc）的青年与操作性BP NOS的青年之间的差异。方法对双相青年研究的过程和结果参与者进行评估，以确定他们是否符合RDCyc标准。比较RDCyc青年和BP NOS青年在基线和超过8年的随访时的特征。结果154例青年（平均年龄11.96（3.3）岁，女性占42%）中，29例符合RDCyc标准。RDCyc青年在基线时更年轻（p =.04）。在随访中，RDCyc青少年更有可能出现破坏性行为障碍（p= ）。01)，并且更容易感到烦躁（p= ）。03)、情绪反应（p =.02）和排斥敏感性（p= .03）。BP NOS青年更容易发生轻躁狂（p= ）。02)，或抑郁(p= 。02)，并且在8年的随访期间，情绪发作的时间往往更早。局限性srdcyc的诊断是回顾性的，并遵循严格的标准，这可能会突出在典型临床条件下和更模糊的标准下不明显的差异。结论rdycyc与BP NOS青年之间差异不大。然而，这些群体分化的方式可能会产生影响；慢性亚综合征情绪症状可能预示着一个严重的，但最终非双相的过程。需要更长时间的随访来确定CycD症状的发展轨迹和结果。
ObjectiveMost studies of pediatric bipolar disorder (BP) combine youth who have manic symptoms, but do not meet criteria for BP I/II, into one “not otherwise specified” (NOS) group. Consequently, little is known about how youth with cyclothymic disorder (CycD) differ from youth with BP NOS. The objective of this study was to determine whether youth with a research diagnosis of CycD (RDCyc) differ from youth with operationalized BP NOS.MethodParticipants from the Course and Outcome of Bipolar Youth study were evaluated to determine whether they met RDCyc criteria. Characteristics of RDCyc youth and BP NOS youth were compared at baseline, and over eight-years follow-up.ResultsOf 154 youth (average age 11.96 (3.3), 42% female), 29 met RDCyc criteria. RDCyc youth were younger (p =.04) at baseline. Over follow-up, RDCyc youth were more likely to have a disruptive behavior disorder (p= .01), and were more likely to experience irritability (p= .03), mood reactivity (p =.02),and rejection sensitivity (p= .03). BP NOS youth were more likely to develop hypomania (p= .02), or depression (p= .02), and tended to have mood episodes earlier in the eight-year follow-up period.LimitationsRDCyc diagnoses were made retrospectively and followed stringent criteria, which may highlight differences that, under typical clinical conditions and more vague criteria, would not be evident.ConclusionThere were few differences between RDCyc and BP NOS youth. However, the ways in which the groups diverged could have implications; chronic subsyndromal mood symptoms may portend a severe, but ultimately non-bipolar, course. Longer follow-up is necessary to determine the trajectory and outcomes of CycD symptoms.