DEVELOPMENTAL SUBTYPES OF JUVENILE BIPOLAR DISORDER

描述(改编自申请人摘要)：这是一份申请 指导临床科学家发展奖(K08)，重点研究 青少年双相情感障碍。双相情感障碍是最常见的 使人丧失行为能力的精神疾病，并与高比率的 发病率、残疾和自杀。虽然从那以后它就被认识到了 Kraepelian时代双相情感障碍可以在儿童时期发病， 关于儿童和青春期形式的科学文献是 斯坎特。初步研究表明，双相情感障碍儿童 目前有严重的易怒，混合的表现和严重的抑郁， 和慢性病程。精神损害严重，精神科住院治疗 在这些孩子中很常见。诊断混乱的主要来源是 青春期前躁狂症是共病和症状重叠的高比率。 患有注意力缺陷多动障碍(ADHD)。因为 易分心、冲动、多动症和情绪不稳定 ADHD和双相情感障碍都存在，鉴别诊断可以 很难。患有BPD的儿童经常符合以下标准 ADHD引发了几个病因学问题：这些孩子非常 严重的ADHD病例？他们的ADHD是因为重叠而被误诊吗 有症状吗？他们真的两种疾病都有吗？在颁奖期内， 应聘者将执行研究计划，进行全面评估 双相情感障碍儿童、青少年及其家庭成员，以努力 青少年双相情感障碍的病程、特点及共病辨析 无序。根据试点工作，候选人建议使用 家系遗传学研究，以检验关于阿尔茨海默病病因学有效性的假说 BPD+ADHD是儿童精神障碍的一个独特亚型。候选人 将评估和比较50名患有BPD+ADHD的儿童(年龄=12岁)和50名青少年 患有BPD+ADHD的50名BPD青少年没有ADHD，以及50名非BPD、非ADHD的青少年 儿科对照，以及每组的一级亲属。 应聘者计划直接面试儿童和青少年 为了验证和描述双相情感障碍的复杂临床 与此诊断相关的图片和发育变异。在……里面 除了研究计划，候选人还计划继续课程学习和 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疾病流行病学。这是另外的 指导和咨询儿童、青少年方面的高级研究人员 和成人精神病学，将包括一个有组织的培训和 旨在促进候选人个人发展的研究 成为一名独立的调查员。

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.