The Effect of Traumatic Events on the Longitudinal Course and Outcomes of Youth with Bipolar Disorder.
The Effect of Traumatic Events on the Longitudinal Course and Outcomes of Youth with Bipolar Disorder.
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创伤事件对患有双相情感障碍的青少年的纵向病程和结果的影响。
DOI：
10.1016/j.jad.2020.05.131
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发表时间：
2020
影响因子：
6.6
通讯作者：
Birmaher,Boris
中科院分区：
文献类型：
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作者：
AndreuPascual,Maria;Levenson,JessicaC;Merranko,John;Gill,MaryKay;Hower,Heather;Yen,Shirley;Strober,Michael;Goldstein,TinaR;Goldstein,BenjaminI;Ryan,NealD;Weinstock,LaurenM;Keller,MartinB;Axelson,David;Birmaher,Boris
背景：在双相情感障碍（BD）患者中，暴露于严重创伤事件（TE）与不良病程和结局相关。然而，有有限的研究与BD青年TE，很少有研究是纵向的。本研究前瞻性地遵循了大样本的BD青年，检查协会的终身TEs与他们的情绪和functioning.Methods：BD参与者（n=375;平均年龄=17;范围8- 25岁）进行了评估，平均每7个月为中位数8.7年。精神病理学和终身创伤史进行了前瞻性评估，使用纵向间隔随访评估，和创伤性事件screening.Results：占协变量，参与者与一个或多个终身TE（84%）表现出较早的BD发病，较差的心理社会功能，更糟糕的情绪症状，和更多的自杀意念，合并症，和家庭精神病理学比那些没有TE。恢复期TE增加复发风险（p<0.02）。更多的TE与较差的情绪过程相关，特别是在暴力/虐待的受害者中（p<0.02）。滥用的参与者（34%的身体; 17%的性）表现出较早的物质使用障碍，自杀倾向和合并症相比，那些没有滥用。比较情绪过程之前和之后的滥用发生，并与参与者没有滥用，表现出恶化的情绪症状后，特别是低/躁狂症（p<0.03）。局限性：前瞻性的数据收集纵向，但回顾性评估在每次随访;给定的近似日期的因果关系不能推断; TEs的严重程度没有assessed.Conclusions：严重的TEs，特别是滥用，与较差的过程和结果之间的BD青年。及时筛查创伤和早期干预可能是必要的，以尽量减少TE的影响。
Background:Exposure to severe Traumatic Events (TEs) has been associated with poor course and outcomes among individuals with Bipolar Disorder (BD). However, there is limited research on TEs among youth with BD, and few studies are longitudinal. This study prospectively followed a large sample of BD youth, examining the associations of lifetime TEs with their mood and functioning.Methods:BD participants (n=375; mean age=17; range 8-25y) were assessed, on average, every 7 months for a median 8.7 years. Psychopathology and lifetime trauma history were prospectively evaluated using the Longitudinal Interval Follow-Up Evaluation, and a traumatic events screening.Results:Accounting for covariates, participants with one or more lifetime TEs (84%) showed earlier BD onset, poorer psychosocial functioning, worse mood symptoms, and more suicidal ideation, comorbidities, and family psychopathology than those without TEs. TEs during recovery periods increased recurrence risk (p<0.02). More TEs were associated with poorer mood course, particularly among victims of violence/abuse (p<0.02). Abused participants (34% physical; 17% sexual) showed earlier onset of substance use disorders, more suicidality and comorbidities compared to those without abuse. Comparisons of mood course before and after abuse occurred, and with participants without abuse, showed worsening mood symptoms after, specifically hypo/mania (p<0.03).Limitations:Prospective data was gathered longitudinally but assessed retrospectively at every follow-up; given approximate dates causality cannot be inferred; TEs severity was not assessed.Conclusions:Severe TEs, particularly abuse, were associated with poorer course and outcomes among BD youth. Prompt screening of trauma and early intervention may be warranted to minimize TEs impact.