Kowatch Robert A, Youngstrom Eric A, Danielyan Arman, Findling Robert L
Department of Psychiatry, Cincinnati Children's Hospital Medical Center/University of Cincinnati Medical Center, Cincinnati, OH 45267, USA.
Bipolar Disord. 2005 Dec;7(6):483-96. doi: 10.1111/j.1399-5618.2005.00261.x.
Using predetermined criteria for study quality and methods, a literature review and meta-analysis of seven reports about pediatric bipolar disorder (BPD) was conducted to determine if there is a consistent picture of the phenomenology and clinical characteristics of BPD in children and adolescents.
Searches were conducted in MedLine and PsycINFO using the terms mania, BPD, children and adolescents, and was limited to published articles in peer-reviewed journals. Seven reports were selected that met the following criteria: a systematic method for the elicitation and reporting of symptoms and clinical characteristics of subjects; subjects were interviewed by a trained researcher or clinician; ages 5-18 years; use of a diagnostic system, either DSM or RDC for categorization; a consensus method for the establishment of the diagnosis of BPD.
Most DSM-IV symptoms of mania were common in the children and adolescents with BPD with the most common symptoms being increased energy, distractibility, and pressured speech. On average, four of five bipolar cases also showed threshold levels of irritable mood and grandiosity, and more than 70% of all cases showed elated/euphoric mood, decreased need for sleep, or racing thoughts. Roughly 69% of cases also showed poor judgment, whereas only half of bipolar cases demonstrated flight of ideas, and slightly more than one-third showed hypersexuality or psychotic features.
The clinical picture that emerges is that of children or adolescents with periods of increased energy (mania or hypomania), accompanied by distractibility, pressured speech, irritability, grandiosity, racing thoughts, decreased need for sleep and euphoria/elation.
运用预先设定的研究质量和方法标准，对七篇关于儿童双相情感障碍（BPD）的报告进行文献综述和荟萃分析，以确定儿童和青少年双相情感障碍的现象学和临床特征是否存在一致的描述。
在MedLine和PsycINFO中进行检索，检索词为“躁狂”“双相情感障碍”“儿童和青少年”，且仅限于同行评审期刊上发表的文章。选取了七篇符合以下标准的报告：采用系统的方法引出和报告受试者的症状及临床特征；由经过培训的研究人员或临床医生对受试者进行访谈；年龄在5至18岁之间；使用诊断系统（DSM或RDC）进行分类；采用共识方法确立双相情感障碍的诊断。
双相情感障碍的儿童和青少年中，大多数DSM-IV躁狂症状较为常见，最常见的症状是精力增加、注意力分散和言语急促。平均而言，五分之四的双相情感障碍病例还表现出易激惹情绪和夸大观念的阈值水平，超过70%的病例表现出情绪高涨/欣快、睡眠需求减少或思维奔逸。约69%的病例还表现出判断力差，而只有一半的双相情感障碍病例表现出思维奔逸，略多于三分之一的病例表现出性欲亢进或精神病性特征。
呈现出的临床图景是儿童或青少年出现精力增加（躁狂或轻躁狂）的时期，伴有注意力分散、言语急促、易激惹、夸大观念、思维奔逸、睡眠需求减少和欣快/高涨情绪。
