Ratheesh Aswin, Berk Michael, Davey Christopher G, McGorry Patrick D, Cotton Susan M
Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre For Youth Mental Health, University of Melbourne, Australia.
Orygen The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre For Youth Mental Health, University of Melbourne, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia; Impact Strategic Research Centre, Deakin University, Australia.
J Affect Disord. 2015 Jul 1;179:65-73. doi: 10.1016/j.jad.2015.03.025. Epub 2015 Mar 21.
Identification of earlier stages of Bipolar Disorder (BD), even prior to the first manic episode, may help develop interventions to prevent or delay the onset of BD. However, reliable and valid instruments are necessary to ascertain such earlier stages of BD. The aim of the current review was to identify instruments that had predictive validity and utility for BD for use in early intervention (EI) settings for the prevention of BD.
We undertook a systematic examination of studies that examined participants without BD I or II at baseline and prospectively explored the predictive abilities of instruments for BD onset over a period of 6 months or more. The instruments and the studies were rated with respect to their relative validity and utility predicting onset of BD for prevention or early intervention. Odds ratios and area under the curve (AUC) values were derived when not reported.
Six studies were included, identifying five instruments that examined sub-threshold symptoms, family history, temperament and behavioral regulation. Though none of the identified instruments had been examined in high-quality replicated studies for predicting BD, two instruments, namely the Child Behavioral Checklist - Pediatric BD phenotype (CBCL-PBD) and the General Behavioral Inventory - Revised (GBI-R), had greater levels of validity and utility.
Non-inclusion of studies and instruments that incidentally identified BD on follow-up limited the breadth of the review.
Instruments that test domains such as subthreshold symptoms, behavioral regulation, family history, and temperament hold promise in predicting BD onset.
识别双相情感障碍（BD）的早期阶段，甚至在首次躁狂发作之前，可能有助于制定干预措施以预防或延缓BD的发作。然而，需要可靠且有效的工具来确定BD的这些早期阶段。本综述的目的是识别对BD具有预测效度和实用性的工具，以便在预防BD的早期干预（EI）环境中使用。
我们对在基线时未患有I型或II型双相情感障碍的参与者进行研究的系统审查，并前瞻性地探讨工具在6个月或更长时间内对双相情感障碍发作的预测能力。根据工具和研究预测双相情感障碍发作以进行预防或早期干预的相对效度和实用性进行评分。未报告时，得出优势比和曲线下面积（AUC）值。
纳入六项研究，确定了五项检查阈下症状、家族史、气质和行为调节的工具。尽管所确定的工具均未在高质量的重复研究中用于预测双相情感障碍，但两项工具，即儿童行为检查表 - 儿童双相情感障碍表型（CBCL-PBD）和修订版一般行为量表（GBI-R），具有更高水平的效度和实用性。
未纳入在随访中偶然发现双相情感障碍的研究和工具，限制了综述的广度。
测试阈下症状、行为调节、家族史和气质等领域的工具在预测双相情感障碍发作方面具有前景。
