Department of Psychology, Assumption College and Department of Psychiatry, University of Massachusettes Medical School, USA.
J Affect Disord. 2011 Jun;131(1-3):312-9. doi: 10.1016/j.jad.2010.11.029. Epub 2010 Dec 18.
This study had two objectives: (1) examine characteristics of aggression in children and adolescents diagnosed with bipolar disorder and (2) determine whether the CBCL pediatric bipolar disorder profile differentiated youngsters with bipolar disorder from youngsters with ADHD.
Children and adolescents referred to a pediatric psychopharmacology clinic were systematically evaluated for psychopathology using a psychiatrist-administered diagnostic interview, parent- and teacher-report rating scales assessing the child's behavior, and child-completed self-report scales. In this sample, 27 children and adolescents were diagnosed with bipolar disorder and 249 youngsters were diagnosed with ADHD without co-occurring bipolar disorder. These two groups were compared to determine whether there were significant differences on various measures of psychopathology.
Youngsters diagnosed with bipolar disorder were more verbally aggressive and exhibited higher levels of reactive aggression than youngsters with ADHD without co-occurring bipolar disorder. Youngsters with bipolar disorder also reported higher levels of depressive symptoms than youngsters with ADHD without bipolar disorder. The CBCL pediatric bipolar disorder profile did not accurately identify youngsters diagnosed with bipolar disorder.
The present findings present a picture of manic youngsters as verbally aggressive and argumentative, who respond with anger when frustrated. Youngsters diagnosed with bipolar disorder and ADHD exhibited significant levels of impulsive behavior and attention problems, but youngsters with bipolar disorder also exhibited significant levels of aggressive behavior and dysphoric mood. Finally, the CBCL pediatric bipolar disorder profile did not accurately identify youngsters who were diagnosed with bipolar disorder.
本研究有两个目的：（1）考察被诊断为双相障碍的儿童和青少年的攻击行为特征；（2）确定 CBCL 儿童双相障碍特征是否能将患有双相障碍的儿童与患有 ADHD 的儿童区分开来。
通过精神病医生进行的诊断访谈、父母和教师报告的儿童行为评定量表以及儿童完成的自我报告量表，对被转介到儿科精神药理学诊所的儿童和青少年进行系统的精神病理学评估。在这个样本中，有 27 名儿童和青少年被诊断为双相障碍，249 名青少年被诊断为 ADHD 而无共病双相障碍。比较这两组，以确定在各种精神病理学测量上是否存在显著差异。
被诊断为双相障碍的青少年比没有共病双相障碍的 ADHD 青少年在言语攻击和反应性攻击方面更为严重。双相障碍的青少年比没有双相障碍的 ADHD 青少年报告了更高水平的抑郁症状。CBCL 儿童双相障碍特征并不能准确识别被诊断为双相障碍的儿童。
目前的研究结果表明，患有躁狂症的青少年表现为言语攻击和争论，当受挫时会愤怒回应。被诊断为双相障碍和 ADHD 的青少年表现出显著的冲动行为和注意力问题，但双相障碍的青少年也表现出显著的攻击行为和情绪低落。最后，CBCL 儿童双相障碍特征并不能准确识别被诊断为双相障碍的儿童。
