Long-term outcomes of youth who manifested the CBCL-Pediatric Bipolar Disorder phenotype during childhood and/or adolescence
Long-term outcomes of youth who manifested the CBCL-Pediatric Bipolar Disorder phenotype during childhood and/or adolescence
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DOI：
10.1016/j.jad.2008.05.024
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发表时间：
2009-03-01
影响因子：
6.6
通讯作者：
Radke-Yarrow, Marian
中科院分区：
文献类型：
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作者：
Meyer, Stephanie E.;Carlson, Gabrielle A.;Radke-Yarrow, Marian
目的：最近的研究确定了儿童行为检查表（CBCL）概况，该概况描述了具有严重攻击性、注意力不集中和情绪不稳定的儿童的特征。这种情况被称为 CBCL-小儿双相情感障碍 (PBD) 表型，因为它常见于患有双相情感障碍的儿童。然而，越来越多的证据表明，CBCL-PBD 可能是识别患有严重功能障碍和广泛精神合并症的儿童的更好工具，而不是双相情感障碍本身。尚无研究对具有 CBCL-PBD 特征的个体进行成年期跟踪，因此其长期影响仍不清楚。目前的作者，，；使用纵向高风险研究的数据，检查了具有 CBCL-PBD 特征的个体从幼儿期到青年期的诊断和功能轨迹。方法：参与者 (n=101) 是一项为期 23 年的研究的一部分，该研究针对有重大情绪障碍风险的青少年，他们定期完成诊断和功能评估。结果：在整个发展过程中，具有 CBCL-PBD 表型的参与者表现出明显的心理社会障碍，自杀想法和行为的发生率增加，自杀风险增加共病焦虑，双相情感障碍。与没有这种表现的参与者相比，青年时期的 B 类人格障碍和多动症。然而，发现任何一种特定疾病的诊断准确性都很低。结论：具有 CBCL-PBD 特征的儿童面临持续、严重的精神症状的风险，包括一般的行为和情绪合并症，特别是双相情感障碍、焦虑、注意力缺陷多动症、B 类人格障碍。然而，该概况的价值可能在于预测持续的合并症和损伤，而不是任何一种特定的 DSM-IV 诊断。 (C) 2008 Elsevier B.V 保留所有权利。
Objective: Recent Studies have identified a Child Behavior Checklist (CBCL) profile that characterizes children with severe aggression, inattention, and mood instability. This profile has been coined the CBCL-Pediatric Bipolar Disorder (PBD) phenotype, because it is commonly seen among children with bipolar disorder. However, mounting evidence suggests that the CBCL-PBD may be a better tool for identifying children with severe functional impairment and broad-ranging psychiatric comorbidities rather than bipolar disorder itself. No studies have followed individuals with the CBCL-PBD profile through adulthood, so its long-term implications remain unclear. The present author,,; examined diagnostic and functional trajectories of individuals with the CBCL-PBD profile from early childhood through young adulthood using data from a longitudinal high-risk study.Method: Participants (n=101) are part of a 23-year study of youth at risk for major mood disorder who have completed diagnostic and functional assessments at regular intervals.Results: Across development, participants with the CBCL-PBD phenotype exhibited marked psychosocial impairment, increased rates of suicidal thoughts and behaviors and heightened risk for comorbid anxiety, bipolar disorder. cluster B personality disorders and ADHD in young adulthood, compared to participants without this presentation. However, diagnostic accuracy for any one particular disorder was found to be low.Conclusions: Children with the CBCL-PBD profile are at risk for ongoing, severe, psychiatric symptomatology including behavior and emotional comorbidities in general, and bipolar disorder, anxiety, ADHD, Cluster B personality disorders in particular. However, the value of this profile may be in predicting ongoing comorbidity and impairment, rather than any one specific DSM-IV diagnosis. (C) 2008 Elsevier B.V All rights reserved.