Child and Adolescent Psychiatry Unit, Psychiatry and Clinical Psychology Department, University of Navarra Clinic, Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA: Navarra Institute for Health Research, Pamplona, Spain.
Child and Adolescent Psychiatry Unit, Psychiatry and Clinical Psychology Department, University of Navarra Clinic, Pamplona, Spain; IdiSNA: Navarra Institute for Health Research, Pamplona, Spain.
J Affect Disord. 2019 Jan 1;242:224-233. doi: 10.1016/j.jad.2018.08.072. Epub 2018 Aug 18.
Paediatric bipolar disorder (BD) has gained validity, and substantial research in the last 20 years has dissipated the controversy surrounding it. However, data on the prevalence, prodromes, phenomenology, and longitudinal stability of paediatric BD are still required.
We reviewed the medical records of all patients (n = 72) with DSM-IV BD evaluated over a 15-year period. We assessed the most frequently present symptoms prior to and at the time of diagnosis, the diagnostic stability of the disorder and its subtypes (I, II and NOS).
Patients [75% boys, median age (interquartile range, IQR) at diagnosis 12.6 (9.6-15.7) years] underwent follow up for a median period of 3.86 (1.8-5.9) years. There was a median delay from symptom onset to diagnosis of 2.3 (1.2-4.8) years. At the time of diagnosis, 37.5% had BD-I, 8.3% BD-II, and 54.2% BD-NOS. At follow-up, 62.5% had BD-I, 8.3% had BD-II, and 23.6% had BD-NOS, whereas 4.2% no longer met the DSM-IV criteria for BD.
Our sample size limited the BD subtype analyses. Some of information was collected retrospectively.
95.8% of our sample retained a BD diagnosis after a median follow-up period of 3.86 years. BD-I patients maintained their diagnosis and subtype of BD. Half of all patients with baseline BD-NOS maintained their BD subtype, but most of the other half showed conversion to BP-I at follow up. Only 4.2% of the sample (all with BD-NOS at baseline) did not meet criteria for BD at follow up, and these patients were stable.
儿科双相障碍（BD）已得到认可，过去 20 年的大量研究消除了围绕它的争议。然而，仍需要关于儿科 BD 的患病率、前驱症状、表现和纵向稳定性的数据。
我们回顾了在 15 年期间评估的所有 DSM-IV BD 患者（n=72）的病历。我们评估了在诊断前和诊断时最常出现的症状，疾病及其亚型（I、II 和 NOS）的诊断稳定性。
患者[75%为男性，诊断时的中位年龄（四分位距，IQR）为 12.6（9.6-15.7）岁]的中位随访时间为 3.86（1.8-5.9）年。从症状出现到诊断的中位时间延迟为 2.3（1.2-4.8）年。在诊断时，37.5%为 BD-I，8.3%为 BD-II，54.2%为 BD-NOS。随访时，62.5%为 BD-I，8.3%为 BD-II，23.6%为 BD-NOS，而 4.2%不再符合 DSM-IV BD 标准。
我们的样本量限制了 BD 亚型分析。部分信息是回顾性收集的。
在中位随访 3.86 年后，我们的样本中有 95.8%保留了 BD 诊断。BD-I 患者维持了他们的诊断和 BD 亚型。所有基线为 BD-NOS 的患者中有一半维持了他们的 BD 亚型，但另一半的大多数患者在随访时转为 BP-I。只有 4.2%的样本（所有基线为 BD-NOS）在随访时不符合 BD 标准，这些患者是稳定的。
