Department of Psychology, The Ohio State University, Columbus, OH 43210-1250, USA.
J Affect Disord. 2013 Jun;148(2-3):431-4. doi: 10.1016/j.jad.2012.06.018. Epub 2012 Sep 5.
Bipolar disorder-not otherwise specified (BD-NOS) is an imprecise, heterogeneous diagnosis that is unstable in youth. This study reports rates of conversion from BD-NOS to BD-I or II in children aged 8-12, and investigates the impact of family history of bipolar disorder and depression on conversion.
As part of the Multi-Family Psychoeducational Psychotherapy (MF-PEP) study, 27 children (6-12 years of age) diagnosed with BD-NOS at baseline were reassessed every 6 months over an 18-month period. Family history of bipolar disorder and depression was assessed at baseline.
One-third of the sample converted from BD-NOS to BD-I or II over 18-months. Having a first-degree relative with symptoms of bipolar disorder and having a loaded pedigree for diagnosis of depression each were associated with conversion from BD-NOS to BD-I or II (odds ratio range: 1.09-3.14; relative risk range: 1.06-2.34).
This study had very low power (range: 10-45) given the small sample size, precluding statistical significance of non-parametric Fisher's Exact test findings.
This study replicates the previous finding of a high rate of conversion from BD-NOS to BD-I or II among youth, and suggests conversion is related to symptoms of bipolar disorder or depression diagnoses in the family history. Additional research is warranted in a larger sample with a longer follow-up period.
未特定双相障碍（BD-NOS）是一种不精确的、异质的诊断，在年轻人中不稳定。本研究报告了 8-12 岁儿童从 BD-NOS 转为 BD-I 或 BD-II 的比率，并调查了双相障碍和抑郁症家族史对转化的影响。
作为多家庭心理教育心理治疗（MF-PEP）研究的一部分，27 名基线时被诊断为 BD-NOS 的儿童在 18 个月的时间内每 6 个月进行一次重新评估。基线时评估了双相障碍和抑郁症家族史。
三分之一的样本在 18 个月内从 BD-NOS 转为 BD-I 或 BD-II。一级亲属有双相障碍症状和有诊断为抑郁症的家族史，这两者都与从 BD-NOS 转为 BD-I 或 BD-II 相关（比值比范围：1.09-3.14；相对风险范围：1.06-2.34）。
鉴于样本量小，本研究的效力非常低（范围：10-45），排除了非参数 Fisher 精确检验结果的统计学意义。
本研究复制了以前的研究结果，即年轻人从 BD-NOS 转为 BD-I 或 BD-II 的比率很高，并表明转化与家族史中双相障碍或抑郁症诊断的症状有关。需要在更大的样本量和更长的随访期进行进一步的研究。
