Longitudinal trajectories of mood symptoms and global functioning in youth at high risk for bipolar disorder.
Longitudinal trajectories of mood symptoms and global functioning in youth at high risk for bipolar disorder.
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DOI：
10.1016/j.jad.2020.08.018
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发表时间：
2020-12-01
影响因子：
6.6
通讯作者：
Miklowitz DJ
中科院分区：
文献类型：
--
作者：
Weintraub MJ;Schneck CD;Walshaw PD;Chang KD;Sullivan AE;Singh MK;Miklowitz DJ
关于双相情感障碍（BD）高危青年的情绪症状和功能的纵向过程知之甚少。识别不同的过程轨迹和这些轨迹的预测因子可能有助于改进治疗方法。本研究基于家族史和早期情绪症状，对126名BD高危青年的情绪症状和功能评分进行了纵向研究。参与者参加了一项以家庭为中心的治疗的随机试验，并进行了纵向随访（平均2.0年，SD = 53.6周）。使用潜在类增长分析（LCGA），我们观察到三种情绪轨迹。所有的年轻人开始研究时都有当前活跃的情绪症状。指数情绪发作后，随访时有“显著改善过程”（n=41，32.5%的样本）、“中度症状过程”（n=21，16.7%）和“主要症状过程”（n=64，50.8%）。在研究的基线上，更严重的抑郁、焦虑和自杀倾向与更差的病程相关。LCGA还揭示了三个轨迹的全球功能，密切对应的症状轨迹，但是，较少的青年表现出功能恢复比表现出症状恢复。在治疗试验的背景下评估情绪轨迹。情绪和功能的评级是基于回顾性回忆。这项研究表明，相当大的异质性，在高风险的BD青年的过程轨迹，与显着比例显示长期缓解的症状。增强心理社会功能的治疗可能与改善BD早期症状的治疗同样重要。
Little is known about the longitudinal course of mood symptoms and functioning in youth who are at high risk for bipolar disorder (BD). Identifying distinct course trajectories and predictors of those trajectories may help refine treatment approaches. This study examined the longitudinal course of mood symptoms and functioning ratings in 126 youth at high risk for BD based on family history and early mood symptoms. Participants were enrolled in a randomized trial of family-focused therapy and followed longitudinally (mean 2.0 years, SD = 53.6 weeks). Using latent class growth analyses (LCGA), we observed three mood trajectories. All youth started the study with current, active mood symptoms. Following the index mood episode, there was a “significantly improving course” (n=41, 32.5% of sample), a “moderately symptomatic course” (n=21, 16.7%), and a “predominantly symptomatic course” (n=64, 50.8%) at follow-up. More severe depression, anxiety, and suicidality at the study’s baseline were associated with a poorer course of illness. LCGA also revealed three trajectories of global functioning that closely corresponded to symptom trajectories; however, fewer youth exhibited functional recovery than exhibited symptomatic recovery. Mood trajectories were assessed within the context of a treatment trial. Ratings of mood and functioning were based on retrospective recall. This study suggests considerable heterogeneity in the course trajectories of youth at high risk for BD, with a significant proportion showing long-term remission of symptoms. Treatments that enhance psychosocial functioning may be just as important as those that ameliorate symptoms in the early stages of BD.
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影响因子：
2
作者：
Miklowitz DJ;Schneck CD;Walshaw PD;Garrett AS;Singh MK;Sugar CA;Chang KD
通讯作者：
Chang KD
DOI：
10.1111/j.1751-9004.2007.00054.x
发表时间：
2008-01-01
影响因子：
4.6
作者：
Jung, Tony;Wickrama, K. A. S.
通讯作者：
Wickrama, K. A. S.
DOI：
10.1111/j.1469-7610.2010.02210.x
发表时间：
2010-04-01
影响因子：
7.6
作者：
Luby, Joan L.;Navsaria, Neha
通讯作者：
Navsaria, Neha
影响因子：
6.6
作者：
Gitlin MJ;Miklowitz DJ
通讯作者：
Miklowitz DJ
影响因子：
5.4
作者：
Hafeman D;Axelson D;Demeter C;Findling RL;Fristad MA;Kowatch RA;Youngstrom EA;Horwitz SM;Arnold LE;Frazier TW;Ryan N;Gill MK;Hauser-Harrington JC;Depew J;Rowles BM;Birmaher B
通讯作者：
Birmaher B