Division of Child and Adolescent Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York 11794; email:
Annu Rev Clin Psychol. 2014;10:529-51. doi: 10.1146/annurev-clinpsy-032813-153702. Epub 2014 Jan 2.
There are two divergent viewpoints on the phenomenology and outcome of bipolar I (BP I) disorder in youth. Disparities evolved as unintended consequences from investigators' inconsistencies both in translating the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R, and DSM-IV criteria and in operationalizing them differently in their standardized assessments. Rates of conservatively diagnosed BP I are lower both in community studies of youths than in adults and from liberally defined BP I in youths. Rates of co-occurring attention-deficit hyperactivity disorder (ADHD) are lower in conservatively than liberally defined children and adolescents with BP I. Rates of both BP I and of ADHD are lower in offspring of BP I probands, and outcome more closely approximates that of adults with BP I in conservatively versus liberally defined children and teens with BP I. Both perspectives can claim evidence for reliability and validity that support their positions. However, the samples are so different that it is difficult to compare studies conducted from these different perspectives.
关于青少年双相情感障碍 I 型（BP I）的现象学和结果，存在两种截然不同的观点。这种差异是由于研究人员在翻译《精神障碍诊断与统计手册》（DSM-III、DSM-III-R 和 DSM-IV）标准时存在不一致，以及在其标准化评估中对这些标准的操作化存在差异，从而产生了意想不到的后果。在青少年的社区研究中，保守诊断的 BP I 发病率低于成年人，而在青少年中，从宽松定义的 BP I 发病率也较低。与宽松定义的 BP I 儿童和青少年相比，保守定义的儿童和青少年共患注意缺陷多动障碍（ADHD）的发病率较低。BP I 先证者的后代中 BP I 和 ADHD 的发病率均较低，且在保守定义的儿童和青少年中，BP I 的预后更接近成人。两种观点都可以声称有可靠性和有效性的证据来支持他们的立场。然而，由于样本差异很大，因此很难比较从这些不同观点进行的研究。
