Longitudinal Family Study of Pediatric Bipolar Disorder

描述(申请人提供)：正如最近在NIMH研究圆桌会议上强调的那样，精神病学领域迫切需要研究，以满足符合双相情感障碍诊断标准的严重情绪和行为障碍儿童的特殊需求。虽然研究涉及临床特征、家族史和治疗，但到目前为止还没有研究涉及双相情感障碍儿童和青少年的纵向病程。为了帮助填补这一空白，并提供有关儿童起病双相情感障碍诊断有效性的重要信息，我们建议进行一项为期五年的跟踪研究，以评估患有DSM-IV双相情感障碍的儿童和青少年的结局。在目前的导师临床科学家发展奖期结束时，我们将确定107名患有双相情感障碍的儿童和青少年(73名儿童，34名青少年；24名女孩，83名男孩)以及296名一级亲属。这个样本在功能的多个领域(精神、认知和心理社会)以及表型(有面部和手的照片)和基因型(有先证者和一级亲属的血液样本)上都有很好的特征。每个先证者及其父母(S)都已由首席调查员在直接临床访谈中进行了评估。在后续评估中，我们将检查先证者和兄弟姐妹在三个功能领域的结果：精神、神经心理和心理社会。我们的目的不仅是确定哪些双相情感障碍儿童继续符合标准，而且还评估随着时间的推移在多个领域的功能。我们对儿童起病双相情感障碍的主要目标是评估：1)坚持和缓解的模式；2)病程；3)共病、神经心理功能和心理社会残疾的模式；4)高危兄弟姐妹的过程和结果；5)与注意缺陷多动障碍的联系；6)与行为/反社会障碍的联系；7)与物质使用障碍的联系；8)儿童行为检查表作为筛查工具的效用。这项对双相情感障碍儿童和青少年的后续研究试图提供关于儿童在多个领域中起病的双相情感障碍的纵向过程和结果的有价值的信息。

DESCRIPTION (provided by applicant): As highlighted at a recent NIMH Research Roundtable, the field of psychiatry is in dire need of research addressing the special needs of children with severe mood and behavioral dysregulation who meet diagnostic criteria for bipolar disorder. Although studies have addressed clinical characteristics, family history, and treatment, no study to date has addressed the longitudinal course of children and adolescents with bipolar disorder. To help fill this gap and contribute important information about the validity of the diagnosis of pediatric-onset bipolar disorder, we propose a five-year follow-up study to assess the outcome of children and adolescents with DSM-IV bipolar disorder. At the completion of the current Mentored Clinical Scientist Development Award period, we will have ascertained 107 children and adolescents (73 children, 34 adolescents; 24 girls, 83 boys) with bipolar disorder along with 296 first-degree relatives. This sample has been well characterized along multiple domains of functioning (psychiatric, cognitive and psychosocial) as well as phenotypically (with photographs of face and hands) and genotypically (with blood samples of probands and first-degree relatives). Each proband and his or her parent(s) has been assessed in direct clinical interview by the Principal Investigator. At the follow-up assessment, we will examine the outcome of the probands and siblings in three domains of functioning: psychiatric, neuropsychological and psychosocial. Our intention is not only to determine which children with bipolar disorder continue to meet criteria or not, but to assess functioning in multiple domains over time. Our main aims regarding pediatric-onset bipolar disorder are to assess: 1) patterns of persistence and remission; 2) course; 3) patterns of comorbidity, neuropsychological functioning and psychosocial disability; 4) the course and outcome of high risk siblings; 5) the association with attention deficit hyperactivity disorder; 6) the association with conduct/antisocial disorder; 7) the association with substance use disorders; 8) the utility of the Child Behavior Checklist as a screening instrument. This follow-up study of children and adolescents with bipolar disorder seeks to contribute valuable information regarding the longitudinal course and outcome of pediatric-onset bipolar disorder in multiple domains.