Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
Indian J Psychiatry. 2011 Oct;53(4):312-8. doi: 10.4103/0019-5545.91904.
Anxiety disorders are common among children and adolescents with bipolar disorder. Among adults, anxiety disorder comorbidity is associated with a more severe form of bipolar disorder and a poorer outcome. There is limited data on the effect of comorbid anxiety disorder on bipolar disorder among children and adolescents.
To study the prevalence of anxiety disorders among adolescents with remitted bipolar disorder and examine their association with the course and severity of illness, global functioning, and quality of life.
We evaluated 46 adolescents with DSM IV bipolar disorder (I and II) who were in remission, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children. We measured quality of life using the Pediatric Quality of Life Inventory and global functioning using the Children's Global Assessment Scale, and then compared these parameters between adolescents with and without current anxiety disorders. We also compared the two groups on other indicators of severity such as number of episodes, suicidal ideation, presence of psychotic symptoms, and response to treatment.
Among the 46 subjects, the prevalence of current and lifetime anxiety disorders were 28% (n=13) and 41% (n=19), respectively. Compared with others, adolescents with anxiety had more lifetime suicidal ideation, more number of episodes, lower physical, psychosocial, and total subjective quality of life, and lower global functioning.
Among adolescents with bipolar disorder, anxiety disorders are associated with a poorer course, lower quality of life, and global functioning. In these subjects, anxiety disorders should be promptly recognized and treated.
焦虑障碍在双相情感障碍的儿童和青少年中很常见。在成年人中,焦虑障碍共病与更严重形式的双相情感障碍和更差的预后相关。关于共病焦虑障碍对儿童和青少年双相情感障碍的影响,数据有限。
研究缓解期双相情感障碍青少年中焦虑障碍的患病率,并探讨其与疾病的病程和严重程度、整体功能和生活质量的关系。
我们使用儿童青少年情感障碍和精神分裂症诊断性访谈表(儿童版)评估了 46 名符合 DSM-IV 双相情感障碍(I 型和 II 型)的缓解期青少年。我们使用儿童生活质量问卷(PedsQL)评估生活质量,使用儿童总体评估量表(CGAS)评估整体功能,然后比较有和无当前焦虑障碍的青少年之间的这些参数。我们还比较了两组在其他严重程度指标上的差异,如发作次数、自杀意念、精神病症状存在情况和治疗反应。
在 46 名受试者中,当前和终身焦虑障碍的患病率分别为 28%(n=13)和 41%(n=19)。与其他患者相比,患有焦虑症的青少年有更多的终生自杀意念、更多的发作次数、更低的生理、心理社会和总体主观生活质量以及更低的整体功能。
在双相情感障碍的青少年中,焦虑障碍与病程较差、生活质量和整体功能较低相关。在这些患者中,应及时识别和治疗焦虑障碍。