Longitudinal Family Study of Pediatric Bipolar Disorder

描述（由申请人提供）：在最近的NIMH研究圆桌会议上强调，精神病学领域迫切需要研究解决患有严重情绪和行为失调的儿童的特殊需求，这些儿童符合双相情感障碍的诊断标准。虽然有研究涉及临床特征、家族史和治疗，但迄今为止还没有研究涉及儿童和青少年双相情感障碍的纵向病程。为了帮助填补这一空白，并提供有关儿科发作双相情感障碍诊断有效性的重要信息，我们提出了一项为期五年的随访研究，以评估患有DSM-IV双相情感障碍的儿童和青少年的结果。在当前的指导临床科学家发展奖阶段结束时，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。该样本在多个功能领域（精神病学、认知和社会心理）、表型（面部和手的照片）和基因典型（先证者和一级亲属的血液样本）都有很好的特征。每个先证者及其父母都由首席研究员在直接临床访谈中进行评估。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：精神病学，神经心理学和社会心理。我们的目的不仅仅是确定哪些患有双相情感障碍的儿童继续符合标准，而是随着时间的推移评估多个领域的功能。我们关于儿科发作双相情感障碍的主要目的是评估：1)持续和缓解的模式；2)课程;3)共病模式、神经心理功能和社会心理障碍；4)高危兄弟姐妹的病程及转归；5)与注意缺陷多动障碍的关联；6)与品行/反社会障碍的关联；7)与物质使用障碍的关联；8)儿童行为检查表作为筛查工具的效用。这项对儿童和青少年双相情感障碍的随访研究旨在提供有关儿科发作双相情感障碍在多个领域的纵向病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.