Bradley Hospital's Pediatric Mood, Imaging, and NeuroDevelopmental (PediMIND) Program and the Alpert Medical School of Brown University, RI 02915, USA.
J Am Acad Child Adolesc Psychiatry. 2013 May;52(5):537-546.e3. doi: 10.1016/j.jaac.2013.03.011.
Bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) are often comorbid or confounded; therefore, we evaluated emotional face identification to better understand brain/behavior interactions in children and adolescents with either primary BD, primary ADHD, or typically developing controls (TDC).
Participants included individuals 7 to 17 years of age (overall sample mean age 12.40 ± 3.01 years), with "narrow-phenotype" pediatric BD (n = 30) or ADHD (n = 38), or typically developing controls (TDC) with no psychiatric disorders themselves or in their first-degree relatives (n = 41). In the BD group, comorbid diagnoses were allowed; however, youth in the ADHD group were excluded for comorbid mood or anxiety disorders. Patient groups were not excluded for psychotropic medication use. Emotional face identification was assessed using the computerized Diagnostic Analysis of Non-Verbal Accuracy (DANVA).
Participants with BD made significantly more identification errors on child happy faces than either TDCs (p = .03) or participants with ADHD (p = .01). Furthermore, youth with BD (0.33 ± 0.55) were more likely than youth with ADHD (0.11 ± 0.31) to make errors on low-intensity child happy faces (p = .05) but not high-intensity happy faces (p = NS). Participants with BD and ADHD made significantly more total errors in child face labeling than did TDCs, although participants with BD and ADHD did not differ from one another.
Our data suggest that youths with BD have specific alterations in emotional face identification of happy faces, an important finding that supports theories that response to positively valenced emotional stimuli may be especially salient in BD. Clinical trial registration information-Brain Imaging and Computer Games in Children With Either Bipolar Disorder, ADHD, Anxiety or Healthy Controls (BBPP); http://clinicaltrials.gov/; NCT01570426.
双相情感障碍（BD）和注意缺陷多动障碍（ADHD）常常共病或混淆；因此，我们评估了情绪面孔识别，以更好地理解患有原发性 BD、原发性 ADHD 或典型发育对照（TDC）的儿童和青少年的大脑/行为相互作用。
参与者包括 7 至 17 岁的个体（总体样本平均年龄 12.40±3.01 岁），包括“窄表型”儿科 BD（n=30）或 ADHD（n=38），或无精神疾病或一级亲属无精神疾病的典型发育对照（n=41）。在 BD 组中允许共病诊断；然而，排除 ADHD 组中伴有心境或焦虑障碍的共病患者。患者组未因使用精神药物而排除在外。情绪面孔识别使用计算机化的非言语准确性诊断分析（DANVA）进行评估。
与 TDC（p=0.03）或 ADHD 参与者（p=0.01）相比，BD 患者在儿童快乐面孔的识别错误上明显更多。此外，BD 青少年（0.33±0.55）比 ADHD 青少年（0.11±0.31）更有可能在低强度儿童快乐面孔上犯错误（p=0.05），而不是高强度快乐面孔（p=NS）。与 TDC 相比，BD 和 ADHD 患者在儿童面孔标记的总错误上显著更多，尽管 BD 和 ADHD 患者彼此之间没有差异。
我们的数据表明，BD 青少年在快乐面孔的情绪面孔识别中存在特定的改变，这一重要发现支持了这样的理论，即对积极情绪刺激的反应可能在 BD 中尤为突出。
临床试验注册信息-双相情感障碍、注意缺陷多动障碍、焦虑或健康对照的脑成像和计算机游戏（BBPP）；http://clinicaltrials.gov/；NCT01570426。
