Longitudinal Assessment of Manic Symptoms

儿童双相情感障碍（PBD）是一系列严重的精神疾病，具有相当大的争议 围绕其临床表现、病程和青春期前的治疗反应。不幸的是 与准确识别儿童中的这些疾病相关的实质性问题。这些困难 源于PBD的症状与其他常见疾病（如ADHD，抑郁症）的重叠 和行为障碍）以及缺乏对差异的前瞻性纵向研究 选择的儿童的临床、治疗反应和功能特征 躁郁症，躁狂症状升高（ESM）。越来越多的科学证据表明， 接受精神病治疗的儿童中有许多患有紧急状态管理。其中一些孩子符合严格的DSM- 原型双相障碍的IV标准，双相1型（BP 1）或双相2型（BP 2）障碍。但 大量患有ESM的儿童不符合DSM的BP 1或BP 2标准。不论其 在评估时的工作诊断，患有ESM的儿童患有高度的 精神病理学和明显的心理社会功能障碍。此外，有限和日期如下- 现有的数据表明，许多患有ESM的儿童不会随着时间的推移而发展为双相情感障碍。 遗憾的是，我们对青少年的现象学、过程或症状演变知之甚少 与ESM一起出席。“躁狂症状的纵向评估”（LAMS）研究是一项合作， 多站点R 01，建议仔细调查儿童和青少年中的无害环境管理。拟建项目 将在五年内在四个地点进行：凯斯西储大学/ 克利夫兰（病例/UHC）、西部精神病研究所和诊所（WPIC）、辛辛那提儿童医院 医学中心/辛辛那提大学（CCHMC/UC）和俄亥俄州州立大学。LAMS建议， 采取了创新步骤，对接受无害环境管理护理的儿童进行大样本筛查， 临床诊断，并仔细检查他们都横截面和随着时间的推移。LAMS将推进 通过提供必要的数据来制定有效的，以证据为基础的标准， 双极表型拟议的研究还将澄清目前关于 儿童双相谱系障碍与ADHD的鉴别诊断

Pediatric bipolar disorder (PBD) is a spectrum of serious psychiatric disorders with considerable controversy surrounding its clinical presentation, course, and treatment response prior to puberty. Unfortunately there are substantial problems associated with accurately identifying these disorders in children. These difficulties stem from the overlap of the symptoms of PBD with other common conditions (such as ADHD, depression and conduct disorder) as well as the lack of prospective longitudinal studies of the differential symptomatology, treatment response and functioning of children selected for the hallmark feature of bipolarity, elevated symptoms of mania (ESM). There is a growing body of scientific evidence that a large number of children who are brought to psychiatric care have ESM. Some of these children meet strict DSM- IV criteria for the prototypic bipolar disorders, bipolar 1 (BP1) or bipolar 2 (BP2) disorder. However, a substantial number of children with ESM do not meet DSM criteria for either BP1 or BP2. Regardless of their working diagnosis at the time of assessment, children with ESM suffer from high degrees of psychopathology and from pronounced psychosocial dysfunction. Furthermore, the limited and dated follow- up data available suggests that many children with ESM do not develop bipolar disorders over time. Regrettably, very little is known about the phenomenology, course, or symptomatic evolution of youngsters who present with ESM. The "Longitudinal Assessment of Manic Symptoms" (LAMS) study is a collaborative, multi-site R01 that proposes to carefully investigate ESM in children and adolescents. The proposed project would be conducted at four sites over five years: Case Western Reserve University/University Hospitals of Cleveland (Case/UHC), Western Psychiatric Institute and Clinic (WPIC), Cincinnati Children's Hospital Medical Center/University of Cincinnati (CCHMC/UC), and Ohio State University. LAMS proposes the innovative step of screening a large sample of children who present for care with ESM, regardless of their clinical diagnoses, and carefully examining them both cross-sectionally and over time. LAMS will advance the field by providing the data necessary to develop valid, evidence-based criteria for a childhood-specific bipolar phenotype. The proposed research will also lend clarification to current controversies regarding the differential diagnosis between bipolar spectrum disorders and ADHD in children.