Dubicka Bernadka, Carlson Gabrielle A, Vail Andy, Harrington Richard
University of Manchester and The Junction Adolescent Unit, Piccadilly, Lancaster LA1 4PW, UK.
Eur Child Adolesc Psychiatry. 2008 Apr;17(3):153-61. doi: 10.1007/s00787-007-0649-5.
To test the hypothesis that US clinicians diagnose prepubertal mania more commonly than UK clinicians.
Five vignettes were presented to 73 UK clinicians and 85 US clinicians. Four cases represented complex scenarios where the diagnosis of mania was thought to be controversial, and one case was a 'classical' case of mania in an older child where it was thought there would be good agreement. Clinicians were asked to determine symptoms of mania, and their preferred diagnoses.
As predicted, overall there were significantly more diagnoses of mania in the US than the UK (P < or = 0.0001). US clinicians were significantly more likely to diagnose mania in three of the four complex cases, and there was good agreement in the case of classical mania. In addition, UK clinicians were significantly more likely to diagnose pervasive developmental disorders and adjustment disorders, whereas obsessive compulsive disorder was more commonly diagnosed in the US.
There may be differences in how clinicians in the US and UK interpret mania-like symptoms in younger children, which may have implications for diagnosis and management.
验证美国临床医生比英国临床医生更常诊断青春期前躁狂症这一假设。
向73名英国临床医生和85名美国临床医生展示了五个病例 vignettes。四个病例呈现出复杂的情况，其中躁狂症的诊断被认为存在争议，另一个病例是大龄儿童的“典型”躁狂症病例，预计在此病例上会有较高的诊断一致性。要求临床医生确定躁狂症状及其首选诊断。
正如预期的那样，总体而言，美国诊断出的躁狂症病例显著多于英国（P≤0.0001）。在四个复杂病例中的三个病例中，美国临床医生诊断出躁狂症的可能性显著更高，而在典型躁狂症病例上诊断一致性良好。此外，英国临床医生诊断广泛性发育障碍和适应障碍的可能性显著更高，而在美国，强迫症的诊断更为常见。
美国和英国的临床医生在如何解读年幼儿童的类似躁狂症状方面可能存在差异，这可能对诊断和管理产生影响。
