Soutullo César A, Chang Kiki D, Díez-Suárez Azucena, Figueroa-Quintana Ana, Escamilla-Canales Inmaculada, Rapado-Castro Marta, Ortuño Felipe
Child and Adolescent Psychiatry Unit, Department of Psychiatry and Medical Psychology, Clínica Universitaria, University of Navarra, Pamplona, Spain.
Bipolar Disord. 2005 Dec;7(6):497-506. doi: 10.1111/j.1399-5618.2005.00262.x.
There is considerable skepticism outside the US over the prevalence of pediatric bipolar disorder (BD). We wished to evaluate the epidemiology of BD in children and adolescents in non-US samples.
We reviewed studies on the prevalence of BD in children and adolescents in international samples. We also describe our sample of 27 children with BD at the University of Navarra.
There are important and frequently overlooked differences in the definition of BD between the International Classification of Diseases 10th edition (ICD-10) and DSM-IV and methodological differences in epidemiological studies that may partially explain international differences in prevalence of pediatric BD. The prevalence of bipolar spectrum disorder in young adults in Switzerland is 11%. In Holland the 6-month prevalence of mania in adolescents was 1.9% and of hypomania 0.9%. Only 1.2% of hospitalized youth (<15 years) in Denmark and 1.7% of adolescents in Finland had BD. In our clinic, the prevalence of DSM-IV BD in children 5-18 years old is 4%, and of any mood disorders 27%. There are also data from Brazil, India and Turkey with varying results.
Relative lack of data, ICD-10 and DSM-IV differences in diagnostic criteria, different levels of recognition of Child and Adolescent Psychiatry as a true specialty in Europe, clinician bias against BD, an overdiagnosis of the disorder in USA and/or a true higher prevalence of pediatric BD in USA may explain these results. US-International differences may be a methodological artifact and research is needed in this field.
美国以外地区对儿童双相情感障碍（BD）的患病率存在相当大的怀疑。我们希望评估非美国样本中儿童和青少年BD的流行病学情况。
我们回顾了国际样本中儿童和青少年BD患病率的研究。我们还描述了纳瓦拉大学27例BD患儿的样本情况。
《国际疾病分类第10版》（ICD - 10）和《精神疾病诊断与统计手册第4版》（DSM - IV）在BD定义上存在重要且常被忽视的差异，流行病学研究中的方法学差异可能部分解释了儿童BD患病率的国际差异。瑞士年轻成年人中双相谱系障碍的患病率为11%。在荷兰，青少年中躁狂的6个月患病率为1.9%，轻躁狂为0.9%。丹麦住院青少年（<15岁）中只有1.2%患有BD，芬兰青少年中这一比例为1.7%。在我们的诊所，5 - 18岁儿童中DSM - IV BD的患病率为4%，任何情绪障碍的患病率为27%。巴西、印度和土耳其也有不同结果的数据。
数据相对缺乏、ICD - 10和DSM - IV诊断标准的差异、欧洲对儿童和青少年精神病学作为一门真正专业的认可程度不同、临床医生对BD的偏见、美国对该疾病的过度诊断和/或美国儿童BD的实际患病率较高，可能解释了这些结果。美国与国际的差异可能是一种方法学假象，该领域需要开展研究。
