Family functioning, social impairment, and symptoms among adolescents with bipolar disorder.
Family functioning, social impairment, and symptoms among adolescents with bipolar disorder.
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DOI：
10.1016/j.jaac.2012.08.005
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发表时间：
2012-10
影响因子：
13.3
通讯作者：
Miklowitz DJ
中科院分区：
文献类型：
--
作者：
Keenan-Miller D;Peris T;Axelson D;Kowatch RA;Miklowitz DJ
社会功能受损在青少年双相情感障碍（BD）中很常见，在多种情况下出现，并持续一段时间。然而，在早发型双相障碍中，与同伴和家庭功能差相关的因素知之甚少。我们使用双相障碍I或II的青少年样本，研究了双相障碍的哪些症状，包括非特异性症状，如注意力不集中、攻击性和焦虑/抑郁，与家庭功能（适应性、凝聚力和冲突）和同伴关系质量有关。在参与一项多地点随机对照试验之前，对患有双相障碍I和II的青少年（N=115, 46%为男性）及其父母进行评估。青少年在前三个月内经历过一次抑郁、躁狂或轻躁，但没有完全缓解。采用家长评量儿童行为量表（CBCL）评估青少年的问题行为。家庭功能通过儿童和父母报告问卷进行评估。抑郁症状与儿童对家庭功能的评分较低有关。与假设相反，适度躁狂症与更好的父母报告的家庭冲突、适应性和凝聚力有关。即使控制了抑郁、狂躁和注意力不集中的影响，在调查和测量中，攻击性与较差的家庭功能有关。这些症状群都与同伴功能无关。在本横断面研究中，儿童双相障碍患者的家庭功能与攻击性最强相关。研究结果表明，在青少年双相情感障碍治疗中，处理攻击性和家庭功能障碍的潜在价值。临床试验注册信息-以家庭为中心的治疗加药物治疗青少年双相情感障碍的有效性；http://clinicaltrials.gov/;NCT00332098
Impaired social functioning is common among youth with bipolar disorder (BD), emerges in multiple settings, and persists over time. However, little is known about factors associated with poor peer and family functioning in the early-onset form of BD. Using a sample of adolescents with BD I or II, we examined which symptoms of BD, including non-specific symptoms such as inattention, aggression, and anxiety/depression, are associated with family functioning (adaptability, cohesion, and conflict) and peer relationship quality. Adolescents (N=115; 46% male) with BD I and II and their parents were evaluated prior to participation in a multi-site randomized controlled trial. Adolescents had experienced an episode of depression, mania, or hypomania within the previous three months and were not in full remission. Adolescents’ problem behaviors were assessed using the parent-rated Child Behavior Checklist (CBCL). Family functioning was assessed via child- and parent-report questionnaires. Depressive symptoms were associated with lower child-ratings of family functioning. Contrary to hypotheses, moderate mania was associated with better parent-reported family conflict, adaptability, and cohesion. Aggression was associated with poorer family functioning across reporters and measures, even when controlling for the effects of depression, mania, and inattention. None of these symptom clusters were associated with peer functioning. Aggression was the strongest correlate of family functioning in pediatric BD in this cross-sectional study. Findings speak to the potential value of addressing aggression and family dysfunction in the treatment of youth with BD. Clinical trial registration information— Effectiveness of Family-Focused Treatment Plus Pharmacotherapy for Bipolar Disorder in Adolescents; http://clinicaltrials.gov/; NCT00332098
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影响因子：
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Neiderhiser, JM;Reiss, D;Plomin, R
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Plomin, R
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