Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder.
Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder.
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DOI：
10.1016/j.jad.2022.01.058
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发表时间：
2022-04-01
影响因子：
6.6
通讯作者：
Birmaher BB
中科院分区：
文献类型：
--
作者：
Diler RS;Merranko JA;Hafeman D;Goldstein TR;Goldstein BI;Hower H;Gill MK;Axelson DA;Ryan N;Strober M;Keller MB;Yen S;Hunt JI;Weinstock LM;Iyengar S;Birmaher BB
目的：在最初病程较差的青少年中，确定与双相情感障碍(BD)改善相关的前瞻性个人和家庭因素。82名有持续不良情绪症状(以病程为主)的BD青年与70名BD青年进行比较，后者在入院时病程较差，但在随访中有所改善(入院时年龄为12.3±3.3岁，而入院时为11.7±3.3岁)。改善的衡量标准是在平均12.8年的随访期内达到最佳状态的时间百分比。对青少年和父母进行了访谈，以评估精神病理学、功能、治疗、家庭功能和精神病理学。与患病组相比，自服药以来，改善组的阈值下抑郁和低/躁狂、注意缺陷多动障碍和破坏性行为障碍显著降低。在患病组中，父母的社会经济地位(SES)随着时间的推移保持不变，但在改善组中逐渐增加。重要的是，SES的变化早于情绪轨迹的改善。预测改善的最有影响的变量是较高的SES，以及没有父母BD和物质使用障碍(SUD)。父母的SSD对父母的SES也有负面影响，这与较差的心境病程直接相关。主要是自我报告的白色样本可能会限制推广；其他可能与结果相关的因素(例如，治疗依从性)尚未确定。除了治疗有症状的BD青少年的情绪/共病精神病，要改善他们的预后，关键是要解决他们父母的BD和SUD问题，并促进父母的教育/就业。
To identify prospectively ascertained individual and family factors that are associated with improvement in Bipolar Disorder (BD) among youths who initially presented with poor course. 82 youths with BD with persistent poor mood symptomatology (“predominantly ill course”) were compared to 70 youths with BD who at intake had poor course, but showed improvement during the follow-up (“ill with improving course”), (ages 12.3 ± 3.3, vs. 11.7 ± 3.3 years old, at intake). Improvement was measured by the percentage of time euthymic during a mean follow-up of 12.8 years. Youths and parents were interviewed to assess psychopathology, functioning, treatment, and familial functioning and psychopathology. Compared to the ill group, since intake, the improving group showed significantly lower subthreshold depression and hypo/mania, Attention Deficit Hyperactivity Disorder, and Disruptive Behavior Disorders. Parental Socioeconomic Status (SES) remained unchanged over time in the ill group, but progressively increased in the improving group. Importantly, the change in SES predated the improvement in the mood trajectory. The most influential variables that predicted improvement were higher SES, and absence of parental BD and Substance Use Disorder (SUD). Parental SUD also negatively affected the parental SES, which was directly associated with worse mood course. Predominantly self-reported White samples may limit generalizability; other factors potentially associated with outcome (e.g., treatment adherence), were not ascertained. In addition to treating mood/comorbid psychopathology in symptomatic BD youths, to improve their prognosis, it is crucial to address their parent’s BD and SUD and promote parental education/employment.
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影响因子：
11.3
作者：
Gerson, AC;Gerring, JP;Denckla, MB
通讯作者：
Denckla, MB
影响因子：
6.2
作者：
Akee, Randall K. Q.;Copeland, William E.;Costello, E. Jane
通讯作者：
Costello, E. Jane
影响因子：
17.7
作者：
Birmaher, Boris;Gill, Mary Kay;Keller, Martin B.
通讯作者：
Keller, Martin B.
DOI：
10.1089/104454603322724850
发表时间：
2003-12-01
影响因子：
1.9
作者：
Axelson, D;Birmaher, BJ;Ryan, N
通讯作者：
Ryan, N
影响因子：
--
作者：
Geller, B;Tillman, R;Bolhofner, K
通讯作者：
Bolhofner, K