Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Faculdades Pequeno Príncipe, Curitiba, PR, Brazil.
J Pediatr (Rio J). 2011 Sep-Oct;87(5):373-81. doi: 10.2223/JPED.2105. Epub 2011 Jul 21.
To review epidemiological and etiologic aspects of diagnosis and treatment of mood disorders (MDs) in children and adolescents, with a focus on essential information for pediatricians.
A literature search on MEDLINE, a review of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fourth edition (text revision) (DSM-IV-TR), and a critical analysis of current diagnostic criteria and scientific evidence regarding the etiology of mood disorders were performed.
We identified diverging opinions for and against the proposition of using the same criteria used for adults, as listed in the DSM-IV-TR, for diagnosing mood disorders in children and adolescents. Although there has been much debate in the literature on this topic in the last decade, there remains a concern that there may be a significant under-diagnosis of cases due to differing methods. Several epidemiological studies conducted in pediatric populations using different criteria and methods make it difficult to interpret the data currently published. Although the field of neurosciences has achieved major advances in understanding these pathologies, additional investigations are needed to gain a clearer picture of how genetic and environmental factors interact and influence the origin and severity of the disease and the patient's response to treatment.
MDs have a high prevalence in childhood and adolescence and have major long-term impacts on sufferer's lives. There is a need to improve diagnostic criteria, adapting them for the pediatric population, with the objective of making it simpler for clinicians, particularly pediatricians, to make diagnoses and initiate early intervention. Advances in the area of epigenetics may aid in the development of new preventative, diagnostic, and therapeutic approaches.
回顾儿童和青少年心境障碍（MDs）的流行病学和病因学方面，重点关注儿科医生的基本信息。
在 MEDLINE 上进行文献检索，回顾美国精神病学会的《精神障碍诊断与统计手册》第四版（文本修订版）（DSM-IV-TR），并对当前心境障碍病因学的诊断标准和科学证据进行批判性分析。
我们发现对于在儿童和青少年中使用 DSM-IV-TR 中列出的成人诊断标准存在不同的意见。尽管在过去十年中，文献中对此主题进行了很多辩论，但仍有人担心由于方法不同，可能会导致大量病例被漏诊。使用不同标准和方法在儿科人群中进行的几项流行病学研究使得难以解释当前发表的数据。尽管神经科学领域在理解这些病理学方面取得了重大进展，但仍需要进一步研究，以更清楚地了解遗传和环境因素如何相互作用并影响疾病的起源和严重程度以及患者对治疗的反应。
MD 在儿童和青少年中患病率较高，对患者的生活有重大的长期影响。需要改进诊断标准，使其适应儿科人群，以便临床医生，特别是儿科医生更简单地进行诊断并进行早期干预。表观遗传学领域的进展可能有助于开发新的预防，诊断和治疗方法。
