Caetano Sheila C, Olvera Rene L, Hunter Kristina, Hatch John P, Najt Pablo, Bowden Charles, Pliszka Steven, Soares Jair C
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
J Affect Disord. 2006 Mar;91(1):33-7. doi: 10.1016/j.jad.2005.12.008. Epub 2006 Jan 27.
Psychosis in pediatric mood disorder patients may be related to suicidal ideation. Bipolar (BP) adolescents are at high risk of completed suicide. We examined whether pediatric BP patients with psychosis have a higher prevalence of suicidality than non-psychotic BP patients. Based on previous findings in adult BP patients, we predicted that pediatric BP patients with psychotic symptoms would have higher prevalence of suicidality, higher occurrence of lifetime psychiatric hospitalizations and worse current Global Assessment of Functioning Scale (GAF) scores compared to non-psychotic BP patients.
We studied 43 BP children and adolescents (mean age +/- S.D = 11.2 +/- 2.8 y, range = 8-17) who did (n = 17) or did not have (n = 26) a lifetime history of psychotic symptoms. Indicators of suicidality (thoughts of death and suicidal ideation, plans, and attempts), psychiatric diagnoses, psychotic symptoms, psychiatric hospitalizations and GAF scores were assessed with the K-SADS-PL interview.
Small sample size, cross-sectional study and exclusion of substance abuse comorbidity.
Pediatric BP patients with a lifetime history of psychotic symptoms compared to BP patients without psychosis were more likely to have thoughts of death (100% versus 69.2%, p = 0.01), suicidal ideation (94.1% versus 42.3%, p = 0.001) and suicidal plans (64.7% versus 15.4%, p = 0.002). Occurrence of psychiatric hospitalization was higher in psychotic BP patients compared to non-psychotic BP patients (82.4% versus 46.2%, p = 0.018).
Psychotic symptoms in pediatric BP patients are associated with suicidal ideation and plans, and psychiatric hospitalizations. Psychotic symptoms are a risk factor for suicidality amongst pediatric BP patients.
小儿情绪障碍患者的精神病可能与自杀意念有关。双相情感障碍（BP）青少年有较高的自杀既遂风险。我们研究了患有精神病的小儿双相情感障碍患者的自杀倾向是否高于非精神病性双相情感障碍患者。基于此前对成年双相情感障碍患者的研究结果，我们预测，与非精神病性双相情感障碍患者相比，有精神病症状的小儿双相情感障碍患者的自杀倾向更高、终生精神科住院发生率更高，且当前功能总体评定量表（GAF）评分更差。
我们研究了43名双相情感障碍儿童和青少年（平均年龄±标准差=11.2±2.8岁，范围=8 - 17岁），其中有（n = 17）或没有（n = 26）终生精神病症状史。使用K-SADS-PL访谈评估自杀倾向指标（死亡念头、自杀意念、计划和企图）、精神科诊断、精神病症状、精神科住院情况和GAF评分。
样本量小、横断面研究以及排除物质滥用共病情况。
有终生精神病症状史的小儿双相情感障碍患者与无精神病的双相情感障碍患者相比，更有可能有死亡念头（100%对69.2%，p = 0.01）、自杀意念（94.1%对42.3%，p = 0.001）和自杀计划（64.7%对15.4%，p = 0.002）。与非精神病性双相情感障碍患者相比，精神病性双相情感障碍患者的精神科住院发生率更高（82.4%对46.2%，p = 0.018）。
小儿双相情感障碍患者的精神病症状与自杀意念、计划以及精神科住院有关。精神病症状是小儿双相情感障碍患者自杀倾向的一个危险因素。
