Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children
Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children
复制标题
DOI：
10.1016/j.biopsych.2006.08.042
复制
发表时间：
2006-11-01
影响因子：
10.6
通讯作者：
Leibenluft, Ellen
中科院分区：
文献类型：
--
作者：
Brotman, Melissa A.;Schmajuk, Mariana;Leibenluft, Ellen
背景：关于儿童双相情感障碍（BD）诊断的争议主要集中在慢性易怒和亢奋的儿童身上。这种综合征被称为“广义双相障碍表型”或严重情绪失调（SMD）。本研究考察流行病学样本中SMD的患病率、并发轴1诊断和纵向结果。方法：数据来自大烟山研究，这是一项纵向流行病学研究。来自儿童和青少年精神病学评估的项目被用于产生SMD标准。在1420名儿童中，9-19岁儿童的终生SMD患病率为3.3%。大多数（67.7%）SMD青少年有轴1诊断，最常见的是注意缺陷/多动障碍（26.9%），行为障碍（25.9%）和/或对立违抗性障碍（24.5%）。在青年期（平均年龄18.3 +/- 2.1岁），在第一波中符合SMD标准的青年（平均年龄10.6 +/- 1.4岁）被诊断为抑郁症的可能性明显高于从未符合SMD标准的青年（优势比为7.2，置信区间为1.3-38.8,p = 0.02）。结论：严重的情绪失调在儿童时期相对常见，并可预测成年早期抑郁症的风险。研究应继续探索SMD患儿的病程。
Background: Controversy concerning the diagnosis of pediatric bipolar disorder (BD) has focused attention on children with chronic irritability and hyperarousal. This syndrome has been called the "broad BD phenotype" or severe mood dysregulation (SMD). This study examines prevalence, concurrent Axis 1 diagnoses, and longitudinal outcome of SMD in an epidemiologic sample.Methods: Data were drawn from the Great Smoky Mountains Study, a longitudinal epidemiological study. Items from the Child and Adolescent Psychiatric Assessment were used to generate SMD criteria.Results. Among 1420 children, the lifetime prevalence of SMD in children ages 9-19 was 3.3%. Most (67.7%) SMD youth bad an Axis 1 diagnosis, most commonly attention-deficit/hyperactivity disorder (26.9%), conduct disorder (25.9%), and/or oppositional defiant disorder (24.5%). In young adulthood (mean age 18.3 +/- 2.1 years), youth who met criteria for SMD in the first wave (mean age 10.6 +/- 1.4 years) were significantly more likely to be diagnosed with a depressive disorder (odds ratio 7.2, confidence interval 1.3-38.8, p =.02) than youth who never met criteria for SMD.Conclusions: Severe mood dysregulation is relatively common in childhood and predicts risk for early adulthood depressive disorders. Research should continue to explore the course of illness in children with SMD.