Carlson Gabrielle A, Findling Robert L, Post Robert M, Birmaher Boris, Blumberg Hilary P, Correll Christoph, DelBello Melissa P, Fristad Mary, Frazier Jean, Hammen Constance, Hinshaw Stephen P, Kowatch Robert, Leibenluft Ellen, Meyer Stephanie E, Pavuluri Mani N, Wagner Karen Dineen, Tohen Mauricio
Department of Child and Adolescent Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA.
J Child Adolesc Psychopharmacol. 2009 Feb;19(1):3-12. doi: 10.1089/cap.2008.100.
The 2006 Research Forum addressed the goal of formulating a research agenda for early-onset bipolar disorder (EOBP) and improving outcome by understanding the risk and protective factors that contribute to its severity and chronicity.
Five work groups outlined barriers and research gaps in EOBP genetics, neuroimaging, prodromes, psychosocial factors, and pharmacotherapy.
There was agreement that the lack of consensus on the definition and diagnosis of EOBP is the primary barrier to advancing research in BP in children and adolescents. Related issues included: the difficulties in managing co-morbidity both statistically and clinically; acquiring adequate sample sizes to study the genetics, biology, and treatment; understanding the EOBP's developmental aspects; and identifying environmental mediators and moderators of risk and protection. Similarly, both psychosocial and medication treatment strategies for children with BP are hamstrung by diagnostic issues. To advance the research in EOBP, both training and funding mechanisms need to be developed with these issues in mind.
EOBP constitutes a significant public health concern. Barriers are significant but identifiable and thus are not insurmountable. To advance the understanding of EOBP, the field must be committed to resolving diagnostic and assessment issues. Once achieved, with adequate personnel and funding resources, research into the field of EOBP will doubtless be advanced at a rapid pace.
2006年研究论坛旨在制定早发性双相情感障碍（EOBP）的研究议程，并通过了解导致其严重程度和慢性化的风险及保护因素来改善治疗结果。
五个工作小组概述了EOBP在遗传学、神经影像学、前驱症状、心理社会因素和药物治疗方面的障碍及研究空白。
大家一致认为，对EOBP定义和诊断缺乏共识是推进儿童和青少年双相情感障碍研究的主要障碍。相关问题包括：在统计学和临床方面处理共病的困难；获取足够样本量以研究遗传学、生物学和治疗方法；理解EOBP的发育方面；以及确定风险和保护的环境中介因素和调节因素。同样，双相情感障碍儿童的心理社会和药物治疗策略也受到诊断问题的阻碍。为推进EOBP研究，需要在考虑这些问题的基础上制定培训和资助机制。
EOBP是一个重大的公共卫生问题。障碍虽大但可识别，因此并非无法克服。为增进对EOBP的理解，该领域必须致力于解决诊断和评估问题。一旦实现，有了充足的人员和资金资源，EOBP领域的研究无疑将快速推进。
