The predictive validity of bipolar at-risk (prodromal) criteria in help-seeking adolescents and young adults: a prospective study
The predictive validity of bipolar at-risk (prodromal) criteria in help-seeking adolescents and young adults: a prospective study
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DOI：
10.1111/bdi.12205
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发表时间：
2014-08-01
影响因子：
5.4
通讯作者：
McGorry, Patrick D.
中科院分区：
文献类型：
--
作者：
Bechdolf, Andreas;Ratheesh, Aswin;McGorry, Patrick D.
目的：目前还没有确定的工具来识别有发展为双相情感障碍风险的个体。我们制定了一套双相情感障碍的超高风险标准[双相情感障碍风险（BAR）]。本研究的主要目的是确定预测效度的BAR criterions.Methods：这是一个为期12个月的前瞻性研究，进行了在Orygen青年健康临床计划，一个公共心理健康计划，为年轻人年龄在15-24岁的大都市墨尔本，澳大利亚。在摄入时，BAR筛查阳性个体和不符合BAR标准的匹配组个体在12个月内进行观察。BAR标准包括一般标准，如处于疾病发作的高峰年龄范围，以及阈值下躁狂，抑郁症加循环情感特征，抑郁症加遗传风险。转换为第一次发作躁狂/轻躁狂定义的DSM-IV躁狂症状的存在超过四天，符合DSM-IV定义的轻躁狂/mania.Results：共559寻求帮助的患者进行了筛选。在符合条件的参与者中，59人（10.6%）符合BAR标准。35名参与者被纳入BAR组，35名匹配的参与者被选为对照组。在随访期间，35例BAR患者中有5例（14.3%）转化为首次发作轻躁狂/躁狂，而非BAR组中无一例转化为轻躁狂/躁狂[chi（2）（1）= 5.38，p = 0.020]。这五个转换器中有四个DSM-IV诊断的双相I或双相IIdisorder.Conclusions：这些研究结果支持的可能性，确定的人发病前躁狂/轻躁狂。建议的标准需要在更大的前瞻性研究中进行进一步评估，随访时间更长。
Objectives: There are no established tools to identify individuals at risk for developing bipolar disorder. We developed a set of ultra-high-risk criteria for bipolar disorder [bipolar at-risk (BAR)]. The primary aim of the present study was to determine the predictive validity of the BAR criteria.Methods: This was a 12-month prospective study that was conducted at Orygen Youth Health Clinical Program, a public mental health program for young people aged 15-24 years in metropolitan Melbourne, Australia. At intake, BAR screen-positive individuals and a matched group of individuals who did not meet BAR criteria were observed over a period of 12 months. The BAR criteria include general criteria such as being in the peak age range for the onset of the disorder, as well as subthreshold mania, depression plus cyclothymic features, and depression plus genetic risk. Conversion to first-episode mania/hypomania was defined by the presence of DSM-IV manic symptoms for more than four days, in line with the DSM-IV definition of hypomania/mania.Results: A total of 559 help-seeking patients were screened. Of the eligible participants, 59 (10.6%) met BAR criteria. Thirty-five participants were included in the BAR group and 35 matched participants were selected to be in the control group. During the follow-up, five BAR patients out of 35 (14.3%) converted to first-episode hypomania/mania as opposed to none in the non-BAR group [chi(2) (1) = 5.38, p = 0.020]. Four out of these five converters had a DSM-IV diagnosis of bipolar I or bipolar II disorder.Conclusions: These findings support the possibility of identification of persons prior to the onset of mania/hypomania. The proposed criteria need further evaluation in larger, prospective studies with longer follow-up periods.