Bakare Muideen O, Agomoh Ahamefule O, Ebigbo Peter O, Onyeama Gabriel M, Eaton Julian, Onwukwe Jojo U, Okonkwo Kevin O
Child and Adolescent Unit, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria.
Int Arch Med. 2009 Jun 1;2(1):16. doi: 10.1186/1755-7682-2-16.
Adolescent onset bipolar disorder often presents with co-morbid disorders of which psychoactive substance use disorders are notable. Mania symptoms and co-morbid psychoactive substance use disorders prone adolescents with bipolar disorder to impulsivity, impaired judgment, and risk taking behavior which often includes sexual risk behavior. There are dearth of information on pattern of co-morbid disorders and sexual risk behavior in adolescent onset bipolar disorder in Nigeria. This study assessed the prevalence and pattern of co-morbid disorders and determined associated factors of sexual risk behavior among adolescents with bipolar disorder.
Socio-demographic information was obtained from the adolescents using socio-demographic questionnaire. Clinical interview, physical examination and laboratory investigations were employed to establish co-morbid disorders in these adolescents during the outpatient follow up visits over a one year period.
A total of forty six (46) adolescents with bipolar disorder were followed up over a one year period. Twenty two (47.8%) of the adolescents had co-morbid disorders with cannabis use disorders, alcohol use disorders, conduct disorder with or without other psychoactive substance use accounting for 23.9%, 8.7%, 13.0% respectively and HIV infection, though a chance finding accounting for 2.2%. Twenty one (45.7%) of the adolescents had positive history of sexual risk behavior, which was significantly associated with presence of co-morbid disorders (p = 0.003), level of religion activities in the adolescents (p = 0.000), and marital status of the parents (p = 0.021).
When planning interventions for children and adolescents with bipolar disorder, special attention may need to be focused on group of adolescents with co-morbid disorders and propensity towards impulsivity and sexual risk behavior. This may help in improving long term outcome in this group of adolescents.
青少年期起病的双相情感障碍常伴有共病，其中精神活性物质使用障碍较为显著。躁狂症状以及共病的精神活性物质使用障碍使双相情感障碍青少年易于出现冲动、判断力受损和冒险行为，其中常包括性风险行为。在尼日利亚，关于青少年期起病的双相情感障碍中共病模式和性风险行为的信息匮乏。本研究评估了双相情感障碍青少年中共病的患病率和模式，并确定了性风险行为的相关因素。
使用社会人口学问卷从青少年中获取社会人口学信息。在为期一年的门诊随访期间，通过临床访谈、体格检查和实验室检查来确定这些青少年的共病情况。
在一年期间共对46名双相情感障碍青少年进行了随访。22名（47.8%）青少年患有共病，其中大麻使用障碍、酒精使用障碍、伴有或不伴有其他精神活性物质使用的品行障碍分别占23.9%、8.7%、13.0%，而HIV感染虽为偶然发现但占2.2%。21名（45.7%）青少年有性风险行为的阳性史，这与共病的存在（p = 0.003）、青少年的宗教活动水平（p = 0.000）以及父母的婚姻状况（p = 0.021）显著相关。
在为双相情感障碍儿童和青少年制定干预措施时，可能需要特别关注患有共病且有冲动和性风险行为倾向的青少年群体。这可能有助于改善这组青少年的长期预后。
