A Pharmacologic Algorithm for Youth Who Are at High Risk for Bipolar Disorder.
A Pharmacologic Algorithm for Youth Who Are at High Risk for Bipolar Disorder.
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针对双相情感障碍高风险青少年的药理学算法。
DOI：
10.1089/cap.2017.0035
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发表时间：
2017
影响因子：
1.9
通讯作者：
Miklowitz,DavidJ
中科院分区：
文献类型：
--
作者：
Schneck,ChristopherD;Chang,KikiD;Singh,ManpreetK;DelBello,MelissaP;Miklowitz,DavidJ
目的：抑郁和短暂的躁狂症状与有一级亲属患有双相情感障碍（BD）I或II的儿童进展为BD的显著风险有关。然而，几乎没有证据可以指导具有这些高危表型的儿童的药物管理。我们提出了一种药物治疗算法的高风险的青年和目前的结果，其使用在一级亲属与BD.Methods的儿童的研究：受试者是40名青年（平均12.7年，范围9-17年）谁有（1）一级亲属与BD I或II，（2）DSM-IV-TR诊断BD未另行说明，抑郁症或循环情感障碍，和（3）抑郁症，躁狂症，轻躁狂症的活动性症状。参与者和他们的家人参加了一项随机试验，研究两种心理社会干预对心境障碍1年病程的影响。在研究开始时，参与者接受了精神病学评估，并获得了药物或现有药物优化以降低症状严重程度。在为期1年的研究中，精神科医生治疗参与者使用的药物治疗算法来治疗抑郁或躁狂症状以及共病焦虑和/或注意力缺陷/多动disorder.Results：在进入研究，25 40（62.5%）的参与者正在服用至少一种精神药物。在1年时，几乎相同比例的人正在服用药物（35人中的22人，63%）。独立评级表明，在84.7%的研究访视中，医生坚持遵守算法。在研究期间，没有患者经历抗抑郁药或兴奋剂诱导的躁狂症。结论：药理学干预的算法方法可能有助于青年的管理（即，年龄<18岁）为BD的高风险。未来的研究应该比较接受算法处方治疗的高危患者与接受常规治疗的患者的结局。临床试验注册信息：双相情感障碍风险青年的早期家庭关注治疗; www.clinicaltrials.gov/; NCT 00943085。
Objective:Depression and brief periods of manic symptoms are linked to a significant risk of progression to bipolar disorder (BD) in children who have a first-degree relative with BD I or II. However, little evidence exists to guide the pharmacologic management of children with these high-risk phenotypes. We propose a pharmacological treatment algorithm for high-risk youth and present results on its use in a study of children with a first-degree relative with BD.Methods:Subjects were 40 youth (mean 12.7 years, range 9–17 years) who had (1) a first-degree relative with lifetime history of BD I or II, (2) DSM-IV-TR diagnoses of BD not otherwise specified, major depressive disorder or cyclothymic disorder, and (3) active symptoms of depression, mania, or hypomania. Participants and their families were enrolled in a randomized trial examining the effects of two psychosocial interventions on the 1-year course of mood disorder. At study intake, participants received a psychiatric evaluation and were offered medications or had existing medications optimized to decrease symptom severity. During the 1-year study, psychiatrists treated participants using a medication algorithm to treat depressive or manic symptoms as well as comorbid anxiety and/or attention-deficit/hyperactivity disorder.Results:At study entry, 25 of 40 (62.5%) of the participants were taking at least one psychiatric medication. At 1 year, nearly an identical proportion were taking medications (22 of 35, 63%). Independent ratings indicated that in 84.7% of the study visits, physicians maintained adherence to the algorithm. No patients experienced antidepressant- or stimulant-induced mania during the study.Conclusions:An algorithmic approach to pharmacologic interventions may aid in the management of youth (i.e., age <18) at high risk for BD. Future studies should compare outcomes in high-risk patients receiving algorithm-prescribed treatment versus those receiving treatment as usual.Clinical Trial Registration Information: Early Family-Focused Treatment for Youth at Risk for Bipolar Disorder; www.clinicaltrials.gov/; NCT00943085.
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DOI：
--
发表时间：
2011
期刊：
Paediatric drugs
影响因子：
--
作者：
M. Goldsmith;Manpreet K. Singh;K. Chang
通讯作者：
K. Chang
DOI：
10.1097/01.chi.0000194566.86160.a3
发表时间：
2006-03-01
影响因子：
13.3
作者：
Chang, K;Saxena, K;Howe, M
通讯作者：
Howe, M
DOI：
10.4088/jcp.08m04301
发表时间：
2009-02
期刊：
The Journal of clinical psychiatry
影响因子：
--
作者：
Goldberg JF;Brooks JO 3rd;Kurita K;Hoblyn JC;Ghaemi SN;Perlis RH;Miklowitz DJ;Ketter TA;Sachs GS;Thase ME
通讯作者：
Thase ME
安非他酮 SR 治疗青少年重度抑郁症的公开试验。
影响因子：
1.5
作者：
C. Glod;A. Lynch;E. Flynn;C. Berkowitz;R. Baldessarini
通讯作者：
R. Baldessarini
DOI：
10.1097/00004583-200104000-00014
发表时间：
2001-04-01
影响因子：
13.3
作者：
Geller, B;Zimerman, B;Soutullo, C
通讯作者：
Soutullo, C