Psychotropic Medication Exposure and Age at Onset of Bipolar Disorder in Offspring of Parents with Bipolar Disorder
Psychotropic Medication Exposure and Age at Onset of Bipolar Disorder in Offspring of Parents with Bipolar Disorder
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DOI：
10.1089/cap.2009.0036
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发表时间：
2010-02-01
影响因子：
1.9
通讯作者：
Simeonova, Diana
中科院分区：
文献类型：
--
作者：
Chang, Kiki D.;Saxena, Kirti;Simeonova, Diana
目的：儿童双相情感障碍（BD）发病前接触精神药物可能对病程产生深远影响。抗抑郁药和兴奋剂都被认为可以加速双相情感障碍的发展，而情绪稳定剂则被认为具有保护作用。我们试图描述一组有 BD 风险的儿童的精神药物暴露情况，并回顾性确定药物暴露对 BD 发病年龄 (AAO) 的影响。方法：受试者为 106 名儿童和青少年，他们的父母中至少有 1 人患有 BD。其中，63 人患有 BDI 或 BD II，43 人患有 BD 亚综合征症状。 AAO 被确定为首次躁狂或轻躁狂发作的最近月份。通过访谈和图表审查确定 AAO 之前过去的精神药物暴露情况。结果：两组的精神药物暴露率均较高。抗抑郁药或兴奋剂暴露与 BD 的早期 AAO 无关。然而，情绪稳定剂暴露与后来的 AAO 相关。结论：患有完全或亚综合征 BD 的儿童在第一次躁狂发作之前经常接触各种精神药物。我们的研究结果并不支持早期接触兴奋剂或抗抑郁药物会导致 BD 的早期 AAO。然而，早期接触情绪稳定剂可能与 AAO 延迟有关。需要纵向研究来澄清这些结果。
Objective: Exposure to psychotropic medications before the onset of bipolar disorder (BD) in children may have profound effects on the course of illness. Both antidepressant and stimulant exposure have been proposed to hasten the course of BD development, whereas mood stabilizers have been proposed as protective. We sought to describe psychotropic medication exposure in a cohort of children at risk for BD and retrospectively determine the effect of medication exposure on age at onset (AAO) of BD.Methods: Subjects were 106 children and adolescents who had at least 1 parent with BD. Of these, 63 had BDI or BD II and 43 had subsyndromal symptoms of BD. AAO was determined as nearest month of first manic or hypomanic episode. Past psychotropic medication exposure prior to AAO was determined through interview and chart review.Results: Both groups had high rates of exposure to psychotropic medications. Antidepressant or stimulant exposure was not correlated with an earlier AAO of BD. However, mood stabilizer exposure was associated with a later AAO.Conclusions: Children with full or subsyndromal BD are frequently exposed to a variety of psychotropic medications before their first manic episode. Our findings do not support that early stimulant or antidepressant exposure leads to an earlier AAO of BD. However, early mood stabilizer exposure may be associated with delayed AAO. Longitudinal studies are needed to clarify these results.