Pediatric bipolar disorder: evidence for prodromal states and early markers
Pediatric bipolar disorder: evidence for prodromal states and early markers
复制标题
DOI：
10.1111/j.1469-7610.2010.02210.x
复制
发表时间：
2010-04-01
影响因子：
7.6
通讯作者：
Navsaria, Neha
中科院分区：
文献类型：
--
作者：
Luby, Joan L.;Navsaria, Neha
背景：儿童双相情感障碍仍然是一个有争议的，但越来越多的诊断障碍，与显着的损害，慢性过程和治疗阻力。因此，寻找早期或早期标志物的风险，为儿童期双相情感障碍后期的预防和/或早期identified.Methods：文献检索进行识别的审查，病例报告和经验性论文解决问题的profession儿童期双相情感障碍。结果：共54篇文章，发现有关双相情感障碍，风险因素为儿童期双相情感障碍后期，儿童期风险为成人双相情感障碍，躁狂症的表现在儿童早期，神经心理学和生物学标志物的儿童期双相情感障碍。对文章的回顾表明：（a）儿童期双相情感障碍可能在疾病发作前就可检测到，（B）前驱症状可能在儿童期表现出发作性，（c）有证据表明可能存在内表型标志物，如执行功能、持续注意力和情感标记缺陷，（d）与功能、结构、与情绪调节有关的大脑结构中明显的生物化学改变，（e）儿童双相情感障碍与早期气质标志物（如情绪调节和行为去抑制）之间的联系，（f）有一些早期但有希望的有效心理治疗预防证据。关于儿童期双相情感障碍早期发生的研究非常有限。基于prosthesis以及高风险状态和可能的内表型标志物的有希望的发现，对双相情感障碍早期标志物的更多控制和有针对性的调查似乎是必要的，并且可能是富有成效的。尽管有证据表明双相情感障碍的特异性标志物至少在某些亚组中是明显的，但在进行此类具有适当对照的纵向研究之前，双相情感障碍的特异性标志物仍将是难以捉摸的。有希望的心理治疗预防计划的发现强调了需要找到儿童期双相情感障碍的特异性和敏感性标志物。
Background:Childhood bipolar disorder remains a controversial but increasingly diagnosed disorder that is associated with significant impairment, chronic course and treatment resistance. Therefore, the search for prodromes or early markers of risk for later childhood bipolar disorder may be of great importance for prevention and/or early identification.Methods:Literature searches were conducted to identify reviews, case reports and empirical papers addressing the issue of prodromes of childhood bipolar disorder.Results:A total of 54 articles were found that related to bipolar prodromes, risk factors for later childhood bipolar disorder, childhood risk for adult bipolar disorder, mania manifestations in early childhood, and neuropsychological and biological markers of childhood bipolar disorder. A review of articles suggest (a) childhood bipolar prodromes may be detectable prior to the onset of the disorder, (b) prodromal symptoms may display episodicity during childhood, (c) there is evidence of possible endophenotypic markers such as deficits in executive function, sustained attention, and emotion labeling, (d) there is a potential association with functional, structural, and biochemical alterations evident in brain structures involved in mood regulation, (e) a link between childhood bipolar disorder with early tempermental markers, such as emotional regulation and behavioral disinhibition and (f) there is some early but promising evidence of effective psychotherapeutic preventions.Conclusions:There has been very limited investigation of early prodromes of childhood bipolar disorder. Based on the promising findings of prodromes as well as high-risk states and possible endophenotypic markers, more controlled and targeted investigations into the early markers of bipolar disorder appear warranted and potentially fruitful. Until such longitudinal studies with appropriate controls are conducted, specific markers for bipolar prodromes will remain elusive, although evidence suggests they are manifest in at least some subgroups. The finding of promising psychotherapeutic prevention programs underscores the need to find specific and sensitive markers of bipolar prodromes in childhood.