DEVELOPMENTAL SUBTYPES OF JUVENILE BIPOLAR DISORDER

描述（改编自申请人的摘要）：这是一个应用程序， 指导临床科学家发展奖（K 08），研究重点是 青少年躁郁症 双相情感障碍是最常见的 使人丧失能力的精神疾病，并与高发病率有关。 发病率残疾和自杀倾向 虽然自那以后， 克雷佩尔时代的双相情感障碍可以在儿童时期发病， 科学文献讨论了它在儿童和青少年时期的形式， 少。 初步研究表明患有躁郁症的儿童 表现为严重易怒，伴有重度抑郁， 慢性病程。 残疾严重，精神病住院治疗 在这些孩子中很常见。 诊断混乱的主要来源， 青春期前躁狂症是合并症和症状重叠的高比率 注意力缺陷多动障碍（ADHD） 因为 注意力不集中、冲动、多动和情绪不稳定， ADHD和双相情感障碍都存在，鉴别诊断可以是 难 患有BPD的儿童经常符合以下标准， ADHD产生了几个疾病分类学问题：这些孩子是不是很 严重的ADHD？ 他们的多动症是由于重叠而误诊的吗 症状？ 他们真的有两种疾病吗？ 在颁奖期间， 候选人将追求一个研究计划，进行全面评估 双相情感障碍儿童、青少年及其家庭成员， 明确青少年双相情感障碍的病程、特点及合并症 disorder. 在试点工作的基础上，候选人提议使用 家族遗传学研究，以检验关于疾病分类学有效性的假设， BPD+ADHD是儿童精神障碍的一种独特亚型。 候选 将评估和比较50名BPD+ADHD儿童（年龄<=12岁），50名青少年 BPD+ADHD，50名BPD w/o ADHD青少年，50名非BPD，非ADHD 儿童对照组以及每组的一级亲属。 候选人计划直接采访儿童和青少年， 双相情感障碍，以验证和描述复杂的临床 与此诊断相关的图片和发育变化。 在 除了研究计划，候选人计划追求课程， 研究设计，生物统计学，遗传学，护理质量和 生活质量研究和精神病流行病学。 此外， 与儿童、青少年、 和成人精神病学，将包括一个有组织的培训计划， 研究旨在促进候选人的个人发展， 成为独立调查员。

DESCRIPTION (Adapted from applicant's abstract): This is an application for a Mentored Clinical Scientist Development Award (K08) with a study focus on juvenile bipolar disorder. Bipolar disorder is one of the most incapacitating psychiatric illnesses and is associated with high rates of morbidity, disability, and suicidality. While it has been recognized since Kraepelinian times that bipolar disorder can have an onset in childhood, the scientific literature addressing its form in childhood and adolescence is scant. Preliminary work suggests that children with bipolar disorder present with severe irritability, mixed presentation with major depression, and chronic course. Impairment is severe and psychiatric hospitalization is common among these children. A leading source of diagnostic confusion in prepubertal mania is the high rate of comorbidity and symptomatic overlap with attention deficit hyperactivity disorder (ADHD). Because distractibility, impulsivity, hyperactivity and emotional lability can be present in both ADHD and bipolar disorder, the differential diagnosis can be difficult. The fact that children with BPD frequently meet criteria for ADHD has created several nosological questions: Are these children very severe cases of ADHD? Is their ADHD a misdiagnosis due to overlapping symptoms? Do they truly have both disorders? During the Award period, the candidate will pursue a Research Plan, undertaking comprehensive assessments of bipolar children, adolescents, and their family members in an effort to distinguish the course, characteristics and comorbidity of juvenile bipolar disorder. Based on pilot work, the candidate proposes to use a family-genetic study to test hypotheses about the nosological validity of BPD+ADHD as a distinct subtype of child psychiatric disorder. The candidate will assess and compare 50 children with BPD+ADHD (age<=12), 50 adolescents with BPD+ADHD, 50 adolescents having BPD w/o ADHD, and 50 non-BPD, non-ADHD pediatric controls, as well as the first degree relatives of each group. The candidate plans to directly interview children and adolescents with bipolar disorder in order to verify and describe the complex clinical picture and developmental variations associated with this diagnosis. In addition to the Research Plan, the candidate plans to pursue coursework and tutorials in research design, biostatistics, genetics, quality of care and quality of life research, and psychiatric epidemiology. This, in addition to mentoring and consultation with senior researchers in child, adolescent and adult psychiatry, will comprise an organized program of training and research aimed at furthering the candidate's personal development towards becoming an independent investigator.