Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths.
Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths.
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DOI：
10.1176/appi.ajp.2010.10050766
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发表时间：
2011-02
期刊：
影响因子：
--
通讯作者：
Leibenluft E
中科院分区：
文献类型：
--
作者：
Leibenluft E
近年来，越来越多的儿童被诊断为双相情感障碍。在某些情况下，情绪不稳定的儿童显然符合目前双相情感障碍的诊断标准，而在另一些情况下，诊断还不清楚。严重情绪失调是一种综合征，其定义是捕捉双相情感障碍儿童的症状，即那些具有严重的、非发作性易怒和躁狂特征的高度觉醒症状，但缺乏双相情感障碍特征的情绪高涨或易怒的明确时期的儿童的症状。患有双相情感障碍的青少年和严重情绪失调的青少年之间的损害水平相当。一项新的文献比较了严重情绪失调儿童和双相情感障碍儿童在纵向病程、家族史和病理生理学方面的差异。临床和社区样本的纵向数据表明，非发作性易怒在年轻人中很常见，成年后与焦虑和单相抑郁障碍的风险增加有关，但与双相情感障碍无关。数据还表明，情绪严重失调的青少年患双相情感障碍的家族率比双相情感障碍患者低。虽然两个患者组的年轻人在面部情绪标签方面都存在缺陷，并且比正常发育的儿童经历了更多的挫折，但两个患者组之间调节这些病理生理异常的大脑机制似乎不同。目前还没有针对严重情绪失调的具体治疗方法，但通过进一步研究证实其是一种有别于双相情感障碍的综合征，应该包括治疗试验。
In recent years, increasing numbers of children have been diagnosed with bipolar disorder. In some cases, children with unstable mood clearly meet current diagnostic criteria for bipolar disorder, and in others, the diagnosis is unclear. Severe mood dysregulation is a syndrome defined to capture the symptomatology of children whose diagnostic status with respect to bipolar disorder is uncertain, that is, those who have severe, nonepisodic irritability and the hyperarousal symptoms characteristic of mania but who lack the well-demarcated periods of elevated or irritable mood characteristic of bipolar disorder. Levels of impairment are comparable between youths with bipolar disorder and those with severe mood dysregulation. An emerging literature compares children with severe mood dysregulation and those with bipolar disorder in longitudinal course, family history, and pathophysiology. Longitudinal data in both clinical and community samples indicate that nonepisodic irritability in youths is common and is associated with an elevated risk for anxiety and unipolar depressive disorders, but not bipolar disorder, in adulthood. Data also suggest that youths with severe mood dysregulation have lower familial rates of bipolar disorder than do those with bipolar disorder. While youths in both patient groups have deficits in face emotion labeling and experience more frustration than do normally developing children, the brain mechanisms mediating these pathophysiologic abnormalities appear to differ between the two patient groups. No specific treatment for severe mood dysregulation currently exists, but verification of its identity as a syndrome distinct from bipolar disorder by further research should include treatment trials.
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影响因子：
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作者：
Beesdo, Katja;Lau, Jennifer Y. F.;Guyer, Amanda E.;McClure-Tone, Erin B.;Monk, Christopher S.;Nelson, Eric E.;Fromm, Stephen J.;Goldwin, Michelle A.;Wittchen, Hans-Ulrich;Leibenluft, Ellen;Erns, Monique;Pine, Daniel S.
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DOI：
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发表时间：
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影响因子：
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通讯作者：
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DOI：
10.1176/appi.ajp.2009.09010043
发表时间：
2010-01
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Brotman MA;Rich BA;Guyer AE;Lunsford JR;Horsey SE;Reising MM;Thomas LA;Fromm SJ;Towbin K;Pine DS;Leibenluft E
通讯作者：
Leibenluft E