Longitudinal Family Study of Pediatric Bipolar Disorder

描述（由申请人提供）：正如在最近的NIMH研究圆桌会议上所强调的那样，精神病学领域迫切需要研究满足双相情感障碍诊断标准的严重情绪和行为失调儿童的特殊需求。虽然研究已经解决了临床特征，家族史和治疗，没有研究迄今已解决的纵向过程中的儿童和青少年双相情感障碍。为了帮助填补这一空白，并提供重要的信息，诊断的有效性，儿科发作的双相情感障碍，我们建议一个为期五年的随访研究，以评估儿童和青少年与DSM-IV双相情感障碍的结果。在目前的指导临床科学家发展奖期间结束时，我们将确定107名儿童和青少年（73名儿童，34名青少年; 24名女孩，83名男孩）患有双相情感障碍，沿着有296名一级亲属。该样本已被充分表征沿着多个功能领域（精神、认知和心理社会）以及表型（面部和手部照片）和基因型（先证者和一级亲属的血液样本）。主要研究者在直接临床访谈中对每位先证者及其父母进行了评估。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或没有，但随着时间的推移，在多个领域的功能进行评估。我们关于儿童期双相情感障碍的主要目的是评估：1）持续和缓解的模式; 2）病程; 3）共病、神经心理功能和心理社会残疾的模式; 4）高危同胞的病程和结局; 5）与注意缺陷多动障碍的关系; 6）与行为/反社会障碍的关系; 7）与物质使用障碍的关系; 8）儿童行为检查表作为筛查工具的实用性。本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童期发作的双相情感障碍在多个领域的纵向病程和结局的有价值信息。

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.