Biederman Joseph, Kwon Anne, Wozniak Janet, Mick Eric, Markowitz Sarah, Fazio Vanessa, Faraone Stephen V
Clinical and Research Program in Pediatric Psychopharmacology of the Child Psychiatry Service, Massachusetts General Hospital, Pediatric Psychopharmacology Unit (WACC 725), 15 Parkman Street, Boston, MA 02114, USA.
J Affect Disord. 2004 Dec;83(2-3):207-14. doi: 10.1016/j.jad.2004.08.005.
Because little is known about gender differences in pediatric bipolar disorder, we evaluated whether gender moderates the expression of pediatric bipolar disorder in a large clinical sample.
Subjects were consecutively referred youth aged 18 years or less who met full criteria for DSM-III-R bipolar disorder (BPD) (females, n=74; BD males, n=224). All subjects were assessed with a structured diagnostic interview and measures of psychosocial and family functioning.
Most of the bipolar subjects (91% of males, 70% of females) also had ADHD. Bipolar disorder was equally prevalent in both genders. Among females and males, severe irritability (83% and 80%, respectively), mixed presentation (87% and 84%, respectively), chronic course (84% and 77%, respectively) and prepubertal onset (78% and 93%, respectively) predominated the clinical picture. We found no meaningful differences between genders in the number of BPD symptoms, type of treatment for BPD (counseling, medication, hospitalization), severity of educational deficits, severity of family and interpersonal functioning or patterns of psychiatric comorbidity.
Because gender does not moderate the clinical expression of pediatric bipolar disorder, our data does not suggest that gender specific criteria for the disorder are warranted.
由于对儿童双相情感障碍的性别差异了解甚少,我们在一个大型临床样本中评估了性别是否会影响儿童双相情感障碍的表现。
研究对象为连续转诊的18岁及以下符合DSM-III-R双相情感障碍(BPD)全部标准的青少年(女性74例;男性224例)。所有受试者均接受结构化诊断访谈以及社会心理和家庭功能测量。
大多数双相情感障碍受试者(男性91%,女性70%)也患有注意力缺陷多动障碍(ADHD)。双相情感障碍在两性中患病率相同。在女性和男性中,严重易激惹(分别为83%和80%)、混合表现(分别为87%和84%)、慢性病程(分别为84%和77%)以及青春期前发病(分别为78%和93%)是主要临床表现。我们发现,在双相情感障碍症状数量、双相情感障碍治疗类型(咨询、药物治疗、住院治疗)、教育缺陷严重程度、家庭和人际功能严重程度或精神共病模式方面,两性之间没有显著差异。
由于性别不会影响儿童双相情感障碍的临床表型,我们的数据并不表明该疾病需要有针对性别的诊断标准。