Are There Developmentally Limited Forms of Bipolar Disorder?
Are There Developmentally Limited Forms of Bipolar Disorder?
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DOI：
10.1037/a0015919
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发表时间：
2009-08-01
影响因子：
4.6
通讯作者：
Sher, Kenneth J.
中科院分区：
文献类型：
--
作者：
Cicero, David C.;Epler, Amee J.;Sher, Kenneth J.
传统上，双相情感障碍被认为是慢性的。然而，最近的流行病学研究表明，双相情感障碍可能存在发育受限的形式。两项具有全国代表性的大型研究表明，双相情感障碍在成年初期的患病率惊人地高（18-24 岁人群中为 5.5%-6.2%），但在 30 岁后半段似乎会得到显着缓解（25-29 岁人群中为 3.1%-3.4%）。尽管由于早期死亡、收容、监禁和无家可归而导致的确定偏差可能是这种减少的部分原因，但患病率分布表明，青春期后期和成年初期的发病率很高，在大多数情况下似乎会自发解决。不同年龄组的症状认可和合并症诊断差异非常小，这表明符合双相情感障碍诊断标准的 18-24 岁青少年会经历临床上显着的障碍以及该疾病的相关后果。需要更细粒度的纵向研究来确定是否存在发育受限形式的双相情感障碍，如果存在，哪些标记可以将这些形式的双相情感障碍与更慢性的病程区分开来。
Bipolar spectrum disorders have traditionally been thought to be chronic in course. However, recent epidemiologic research suggests that there may be developmentally limited forms of bipolar disorder. Two large, nationally representative studies reveal a strikingly high prevalence of bipolar disorders in emerging adulthood (5.5%-6.2% among 18-24-year-olds) that appear to resolve substantially during the latter half of the 3rd decade of life (3.1%-3.4% among 25-29-year-olds). Although ascertainment bias due to early mortality, institutionalization, incarceration, and homelessness may account for some of this reduction, the prevalence distribution suggests a high incidence in late adolescence and emerging adulthood that appears to resolve spontaneously in most cases. There were very few differences across age groups in symptom endorsement and comorbid diagnoses, suggesting that 18-24-year-olds that meet criteria for bipolar diagnoses experience clinically significant impairment and associated consequences of the disorder. More fine-grained longitudinal research is needed to determine whether developmentally limited forms of bipolar disorder exist and, if so, what markers might distinguish these forms of the disorder from more chronic courses.