CBCL-pediatric bipolar disorder phenotype:: severe ADHD or bipolar disorder?
CBCL-pediatric bipolar disorder phenotype:: severe ADHD or bipolar disorder?
复制标题
DOI：
10.1007/s00702-007-0823-4
复制
发表时间：
2008-02-01
影响因子：
3.3
通讯作者：
Boelte, S.
中科院分区：
文献类型：
--
作者：
Holtmann, M.;Goth, K.;Boelte, S.
背景。在患有儿科双相情感障碍 (PBD) 的儿童中，儿童行为检查表（CBCL-PBD 概况）已发现多动、抑郁/焦虑和攻击性的持续升高模式。本研究的目的是评估儿童精神病学样本中 CBCL-PBD 特征的患病率，并确定 CBCL-PBD 患者的 ICD-10 诊断。方法。我们研究了 939 名连续转介的 4-18 岁儿童和青少年样本。 ICD-10 出院诊断是在共识会议上确定的。 CBCL 4-18 由父母完成，作为诊断常规的一部分。结果。共有 62 名受试者（6.6%；95% CI=5.2-8.4）符合 CBCL-PBD 表型标准。超过 75% 的 CBCL-PBD 受试者被临床诊断患有破坏性行为障碍（ADHD、ODD 和 CD）。两名患者（占总样本的 0.2%）被正式诊断为双相情感障碍，但未显示 CBCL-PBD 表型。结论。德国有相当多的儿童因攻击性、焦虑、抑郁和注意力问题等混合表型而被转诊至精神科治疗。我们的研究表明，与其他国家使用不同诊断方法报告的患病率和临床特征相当。然而，CBCL-PBD 表型并不符合双相情感障碍的临床共识诊断，而是符合严重的破坏性行为障碍。
Background. In children with pediatric bipolar disorder (PBD), a consistent pattern of elevations in hyperactivity, depression/anxiety, and aggression has been identified on the child behavior checklist (CBCL-PBD profile). The aim of the present study was to estimate the prevalence of the CBCL-PBD profile in a child psychiatric sample, and to determine ICD-10 diagnoses in CBCL-PBD patients.Methods. We studied a sample of 939 consecutively referred children and adolescents, aged 4-18 years. ICD-10 discharge diagnoses were established in consensus conferences. The CBCL 4-18 was completed by parents as part of the diagnostic routine.Results. A total of 62 subjects (6.6%; 95% CI=5.2-8.4) met criteria for the CBCL-PBD phenotype. More than 75% of CBCL-PBD subjects were clinically diagnosed with disruptive behavior disorders (ADHD, ODD, and CD). Two patients (0.2% of the total sample) received a formal diagnosis of bipolar disorder, but did not show the CBCL-PBD phenotype.Conclusions. A considerable number of children in Germany are referred to psychiatric care with a mixed phenotype of aggression, anxiety, depression and attention problems. Our study demonstrated a comparable prevalence and similar clinical characteristics as reported from other countries using different diagnostic approaches. However, the CBCL-PBD phenotype does not correspond with clinical consensus diagnoses of bipolar disorder, but with severe disruptive behavior disorders.