Geller Barbara, Tillman Rebecca, Bolhofner Kristine
Washington University School of Medicine, Department of Psychiatry, St. Louis, Missouri 63110, USA.
J Child Adolesc Psychopharmacol. 2007 Apr;17(2):217-22. doi: 10.1089/cap.2007.0017.
Recent data from several large studies of pediatric bipolar I disorder reported baseline (current) episode duration ranging from less than a month to >or=1 year. These data may reflect actual sample differences, but the absence of uniformly applied definitions of episode duration, number of lifetime episodes and daily rapid cycling patterns during episodes may also account for these differences.
Proposals for definitions of episode and cycling phenomena were based upon data from the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS).
Episode would be used for the interval between onset and offset of full DSM-IV criteria for bipolar I disorder. Cycling would be used only to describe daily (ultradian) switching of mood states that occurs during an episode.
Historically, in the adult bipolar literature the words "episode" and "cycle" were used interchangeably. "Rapid cycling," in this earlier literature, actually referred to multiple episodes per year. To avoid confusing episodes with daily cycling, the proposal is to use "episode" for the duration of DSM-IV criteria, to use "cycling" for daily switching phenomena during an episode, and to replace the historical term "rapid cycling" with "multiple episodes per year." These clarifications will be especially important for phenomenological research on preschool populations.
近期多项关于儿童双相I型障碍的大型研究数据显示，基线（当前）发作持续时间从不足1个月到≥1年不等。这些数据可能反映了实际样本差异，但发作持续时间、终生发作次数以及发作期间每日快速循环模式缺乏统一应用的定义，这也可能是造成这些差异的原因。
发作和循环现象的定义提案基于圣路易斯华盛顿大学情感障碍和精神分裂症儿童日程表（WASH-U-KSADS）的数据。
发作将用于双相I型障碍完整DSM-IV标准从起病到缓解的时间段。循环仅用于描述发作期间出现的每日（超日节律）情绪状态转换。
从历史上看，在成人双相情感障碍文献中，“发作”和“循环”这两个词是互换使用的。在早期文献中，“快速循环”实际上指的是每年多次发作。为避免将发作与每日循环相混淆，建议将DSM-IV标准的持续时间用“发作”表示，将发作期间的每日转换现象用“循环”表示，并用“每年多次发作”取代历史术语“快速循环”。这些澄清对于学龄前儿童的现象学研究尤为重要。
