Findling Robert L, Youngstrom Eric A, McNamara Nora K, Stansbrey Robert J, Demeter Christine A, Bedoya Denise, Kahana Shoshana Y, Calabrese Joseph R
Department of Psychiatry, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH 44106, USA.
Bipolar Disord. 2005 Dec;7(6):623-34. doi: 10.1111/j.1399-5618.2005.00260.x.
The objectives of this study were to: (i) describe the phenomenology of youths diagnosed with subsyndromal bipolar disorders; (ii) describe the phenomenology of youngsters who are the children of bipolar parents, who are also experiencing subsyndromal symptoms of bipolar disorder (patients with 'cyclotaxia'); and (iii) explore which symptoms may be most useful in identifying youths with cyclotaxia.
Four hundred outpatients between the ages of 5 and 17 years received a diagnostic assessment and psychometric questionnaires pertaining to mood symptomatology and psychosocial functioning. Parental diagnostic information was also obtained. Children and adolescents were assigned to one of three diagnostic groups: a 'syndromal bipolar disorder (BP)' group (n = 118), a 'sub-syndromal bipolar (SUB-BP)' group (n = 75), or a 'non-bipolar (NON-BP)' group (n = 207). In addition, based on parental diagnoses, youths were assigned to either a high genetic risk group (n = 167) or a low genetic risk group (n = 233).
Youths with subsyndromal bipolar disorders were found to have intermediate degrees of manic symptoms than youths with bipolar disorder and youths without a bipolar diagnosis. Offspring of parents having a bipolar disorder were more likely to show symptoms of hypomania and mania than youths without a bipolar parent. Youths at genetic risk for developing a bipolar disorder were not found to be at higher risk for having a diagnosis of attention-deficit hyperactivity disorder or a disruptive behavior disorder. Finally, results suggest that elevated mood with irritability and rapid mood fluctuations are the key distinguishing characteristics of 'cyclotaxia'.
There exists a group of youngsters who are the offspring of a parent/parents with a bipolar disorder who do not suffer from BP 1 or BP 2, yet have elevated mood symptoms and psychosocial dysfunction. As a result of these observations, treatment studies are needed for youths with 'cyclotaxia'.
本研究的目的是：（i）描述被诊断为亚综合征双相情感障碍的青少年的症状表现；（ii）描述双相情感障碍患者的子女且也有双相情感障碍亚综合征症状（“循环性气质”患者）的青少年的症状表现；（iii）探究哪些症状对于识别有循环性气质的青少年可能最有用。
400名年龄在5至17岁之间的门诊患者接受了诊断评估以及与情绪症状和心理社会功能相关的心理测量问卷。还获取了父母的诊断信息。儿童和青少年被分为三个诊断组之一：“综合征双相情感障碍（BP）”组（n = 118）、“亚综合征双相情感障碍（SUB - BP）”组（n = 75）或“非双相情感障碍（NON - BP）”组（n = 207）。此外，根据父母的诊断，青少年被分为高遗传风险组（n = 167）或低遗传风险组（n = 233）。
发现患有亚综合征双相情感障碍的青少年的躁狂症状程度介于患有双相情感障碍的青少年和未被诊断为双相情感障碍的青少年之间。双相情感障碍患者的子女比没有双相情感障碍父母的青少年更有可能表现出轻躁狂和躁狂症状。未发现有患双相情感障碍遗传风险的青少年被诊断为注意力缺陷多动障碍或破坏性行为障碍的风险更高。最后，结果表明情绪高涨伴易怒和快速情绪波动是“循环性气质”的关键区别特征。
存在一群青少年，他们是双相情感障碍患者的子女，虽未患BP1或BP2，但有情绪症状加剧和心理社会功能障碍。基于这些观察结果，需要对患有“循环性气质”的青少年进行治疗研究。
