Jerrell Jeanette M, Shugart Margaret A
Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC 29203, USA.
J Affect Disord. 2004 May;80(1):29-35. doi: 10.1016/S0165-0327(03)00045-4.
Presenting symptoms of and treatments used for child/adolescent and adult patients diagnosed with bipolar I disorder in a state mental health system are described and compared.
Medical records were reviewed for 267 cases of bipolar I disorder reported in the statewide patient information system.
The child/adolescent patients were significantly more likely to have irritability documented, be treated with stimulant medications, and meet the criteria for major depression while adults were significantly more likely to have a broader array of documented symptoms: euphoria, fatigue, trouble concentrating, and hyper-religiosity. Suicidality (thoughts and gestures) was higher in both age groups than previously reported in the clinical literature. No difference was evident in the mood-related pharmacotherapy. Child/adolescent cases were seen more often for re-evaluations, medication visits, and individual and family therapy sessions, whereas adult cases were more likely to receive case management services and less-frequent medication monitoring visits.
Youths with bipolar I disorder were more likely to present with irritability and depressive symptoms, and be treated with stimulants and a range of therapeutic interventions, whereas adults with more broadly documented symptoms were receiving minimal treatment services.
描述并比较了在州立心理健康系统中被诊断为双相I型障碍的儿童/青少年和成年患者的呈现症状及所采用的治疗方法。
对全州患者信息系统中报告的267例双相I型障碍病例的病历进行了回顾。
儿童/青少年患者更有可能被记录有易激惹症状，接受兴奋剂药物治疗，并符合重度抑郁的标准，而成年患者更有可能有更广泛的记录症状：欣快、疲劳、注意力不集中和过度虔诚。两个年龄组的自杀倾向（想法和行为）均高于临床文献中先前报道的水平。在与情绪相关的药物治疗方面没有明显差异。儿童/青少年病例更常进行重新评估、药物就诊以及个体和家庭治疗，而成年病例更有可能接受病例管理服务且药物监测就诊频率较低。
双相I型障碍的青少年更有可能出现易激惹和抑郁症状，并接受兴奋剂和一系列治疗干预，而有更广泛记录症状的成年人接受的治疗服务最少。
