Department of Psychiatry and Pediatrics, Stony Brook University School of Medicine, Stony Brook, NY, USA.
Department of Psychology, Stony Brook University, Stony Brook, NY, USA.
J Child Psychol Psychiatry. 2018 Jul;59(7):740-743. doi: 10.1111/jcpp.12873.
The bipolar disorder diagnosis in prepubertal children became popular because it answered a clinical need to treat the explosive behavior component of irritability and the hope that antimanic strategies would be helpful. Poor definition of episodes resulted in mixing chronic and episodic irritability in samples of children with bipolar disorder. The subsequent dramatic increase in neuroleptic use is a testimony to the importance of the problem of irritability and our need to better understand it. Insofar as our use of the term irritability conflates proneness to anger with the subsequent aggressive response, it will again not be clear who is being studied. We need to uncouple the mood and behavior aspects of irritability for further study or we will have traded the imprecision of "bipolar" for the imprecision of irritability.
双相障碍在青春期前儿童中的诊断变得流行起来，因为它满足了治疗易激惹中爆发性行为成分的临床需求，并且人们希望抗躁狂策略会有所帮助。发作的定义不明确导致在双相障碍儿童样本中混合了慢性和发作性易激惹。随后神经阻滞剂的大量使用证明了易激惹问题的重要性，以及我们需要更好地理解它。就我们使用易激惹这个术语而言，它将易愤怒倾向与随后的攻击反应混为一谈，因此将不清楚我们正在研究谁。我们需要将易激惹的情绪和行为方面分开进行进一步研究，否则我们将用“双相”的不精确性来换取易激惹的不精确性。
