Timmins Vanessa, Swampillai Brenda, Hatch Jessica, Scavone Antonette, Collinger Katelyn, Boulos Carolyn, Goldstein Benjamin I
TIMMINS, SWAMPILLAI, HATCH, SCAVONE, COLLINGER, BOULOS, and GOLDSTEIN: Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
J Psychiatr Pract. 2016 Jan;22(1):31-41. doi: 10.1097/PRA.0000000000000118.
Family conflict exacerbates the course of bipolar disorder (BP) among adults. However, few studies have examined family conflict among adolescents with BP, and fewer have looked at adolescent-reported and parent-reported family conflict separately.
Subjects were 89 adolescents, aged 13 to 19 years, with a diagnosis of BP on the basis of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL). Subjects were divided into high-conflict and low-conflict groups using a median split on the Conflict Behavior Questionnaire (child report and parent report). The χ(2) analyses and independent samples t tests were performed for univariate analyses. Multivariable logistic regression analyses were performed on variables with P<0.2.
Parent-reported and adolescent-reported Conflict Behavior Questionnaire scores were significantly correlated (r=0.50, P<0.001). High parent-reported family conflict was positively associated with recent manic symptoms, externalizing comorbidities, and dimensional scores reflecting emotional dysregulation. High adolescent-reported family conflict was positively associated with recent manic symptoms and emotional dysregulation, and negatively associated with socioeconomic status and lifetime psychiatric hospitalization. Bipolar subtype was significantly associated with high versus low family conflict.
The limitations of this study included being a cross-sectional study, use of a medium-sized sample, and lack of a control group.
Despite substantial agreement between adolescents and parents regarding the amount of family conflict, there were meaningful differences in the factors associated with adolescent-reported and parent-reported conflict. These findings demonstrate the importance of ascertaining family conflict from adolescents as well as from parents. Moreover, these findings can potentially inform family therapy, which is known to be effective for adolescents with BP.
家庭冲突会加剧成年人双相情感障碍（BP）的病程。然而，很少有研究探讨患有双相情感障碍的青少年中的家庭冲突，更少有人分别研究青少年报告的和父母报告的家庭冲突。
研究对象为89名年龄在13至19岁之间、根据学龄儿童情感障碍和精神分裂症评定量表（适用于当前和一生版本，KSADS-PL）诊断为双相情感障碍的青少年。使用冲突行为问卷（儿童报告和父母报告）的中位数分割法将研究对象分为高冲突组和低冲突组。进行χ(2)分析和独立样本t检验以进行单变量分析。对P<0.2的变量进行多变量逻辑回归分析。
父母报告的和青少年报告的冲突行为问卷得分显著相关（r=0.50，P<0.001）。父母报告的高家庭冲突与近期躁狂症状、外化共病以及反映情绪失调的维度得分呈正相关。青少年报告的高家庭冲突与近期躁狂症状和情绪失调呈正相关，与社会经济地位和终生精神病住院呈负相关。双相情感障碍亚型与高家庭冲突和低家庭冲突显著相关。
本研究的局限性包括为横断面研究、样本量中等以及缺乏对照组。
尽管青少年和父母在家庭冲突量方面有很大的一致性，但与青少年报告的冲突和父母报告的冲突相关的因素存在有意义的差异。这些发现证明了从青少年以及父母那里确定家庭冲突的重要性。此外，这些发现可能为已知对患有双相情感障碍的青少年有效的家庭治疗提供参考。
