Oddział Kliniczny Psychiatrii i Psychoterapii Wieku Rozwojowego Katedry Psychiatrii i Psychoterapii Śląskiego Uniwersytetu Medycznego w Katowicach.
Centrum Pediatrii im. Jana Pawła II w Sosnowcu Sp. z o.o.
Psychiatr Pol. 2020 Mar 29;54(1):35-50. doi: 10.12740/PP/OnlineFirst/92740.
Bipolar disorder (BD) is characterized by pathological changes in mood as well as recurring episodes of mania, hypomania, depression and mixed symptoms. In recent years, the number of BD diagnoses has risen considerably in children and adolescents. Itis believed that anaverage rate of prevalence of bipolar spectrum disorder in the pediatric population is 1.8%, and BD type I - 1.2%, and the prevalence of the disorder increases with the age of patients. Despite the same diagnostic criteria, there are premises that suggest thatthe symptoms of the disorder are present with a different frequency among children and adolescents than in adults. The most frequent manic symptom in persons with childhood-onset of the illness is thought to be irritability, and in adolescence -hyperactivity. BD in children and adolescent population is accompanied by a high rate of comorbid psychiatric conditions. Attention deficit hyperactivity disorder and borderline personality disorder constitute particular diagnostic challenges. Early onset of BP is linked with a more severe course of the illness, worse prognosis, and a higher suicidal rate. Pharmacotherapy of BD in the pediatric population includes 1st and 2nd generation mood stabilizers, while their efficacy and safety profiles are different than in adults. The American Food and Drug Administration recommends treating manic episodes in young persons with lithium, aripiprazole, quetiapine, risperidone, olanzapine and depressive episodes with a combination therapy of olanzapine and fluoxetine.
双相情感障碍（BD）的特征是情绪发生病理性变化，以及反复发作的躁狂、轻躁狂、抑郁和混合症状。近年来，儿童和青少年的 BD 诊断数量显著增加。据信，儿科人群中双相谱系障碍的平均患病率为 1.8%，I 型双相障碍为 1.2%，且该障碍的患病率随患者年龄的增长而增加。尽管有相同的诊断标准，但有前提假设表明，该障碍的症状在儿童和青少年中的出现频率与成人不同。在发病于童年的患者中，最常见的躁狂症状被认为是易怒，而在青少年中则是多动。儿童和青少年人群中的 BD 伴有很高的共病精神状况发生率。注意力缺陷多动障碍和边缘型人格障碍构成了特定的诊断挑战。BP 的早期发病与更严重的疾病病程、更差的预后和更高的自杀率相关。儿科人群中的 BD 药物治疗包括第一代和第二代心境稳定剂，但其疗效和安全性特征与成人不同。美国食品和药物管理局建议使用锂、阿立哌唑、喹硫平、利培酮、奥氮平和氟西汀联合治疗来治疗年轻人的躁狂发作，以及使用奥氮平和氟西汀联合治疗来治疗抑郁发作。
