Suominen Kirsi, Mantere Outi, Valtonen Hanna, Arvilommi Petri, Leppämäki Sami, Paunio Tiina, Isometsä Erkki
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Bipolar Disord. 2007 Nov;9(7):698-705. doi: 10.1111/j.1399-5618.2007.00388.x.
Our aim was to obtain a comprehensive view of differences between bipolar disorder (BD) patients with onset at early versus adult age in a representative study cohort.
In the Jorvi Bipolar Study (JoBS), 1,630 psychiatric in- and outpatients were systematically screened for BD using the Mood Disorder Questionnaire (MDQ). A total of 191 bipolar I and II patients with a current DSM-IV episode were interviewed to obtain information about age at onset of mood symptoms, clinical course, treatment, comorbidity, and functional status. The patients were classified as either early onset (<18 years) or adult onset.
One-third of subjects with BD (58/191, 30%) had early onset. This was associated with female gender, more lifetime psychotic symptoms, greater overall comorbidity, and a greater length of time from first episode to treatment.
Although BD patients with early age at onset have more severe clinical features and illness course, the delays from first episode to treatment and to correct diagnosis are longer than for those with adult onset disorder. To reduce morbidity rates related to the most severe forms of BD, the recognition and diagnosis of BD during adolescence needs to be improved.
在一项具有代表性的研究队列中，我们旨在全面了解早发型与成年发病型双相情感障碍（BD）患者之间的差异。
在约尔维双相情感障碍研究（JoBS）中，使用心境障碍问卷（MDQ）对1630名精神科门诊和住院患者进行了双相情感障碍的系统筛查。对总共191例目前处于DSM-IV发作期的双相I型和II型患者进行访谈，以获取有关情绪症状发作年龄、临床病程、治疗、共病情况和功能状态的信息。这些患者被分类为早发型（<18岁）或成年发病型。
三分之一的双相情感障碍患者（58/191，30%）为早发型。这与女性性别、更多的终生精神病性症状、更高的总体共病率以及首次发作到治疗的时间更长有关。
尽管早发型双相情感障碍患者具有更严重的临床特征和病程，但从首次发作到治疗以及到正确诊断的延迟时间比成年发病型患者更长。为了降低与最严重形式的双相情感障碍相关的发病率，需要改善青少年期双相情感障碍的识别和诊断。
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