Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA; Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI, 02915, USA.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA; Department of Psychiatry, School of Medicine, University of California San Diego, 4510 Executive Drive, San Diego, CA, 92123, USA.
J Affect Disord. 2020 Jun 15;271:248-254. doi: 10.1016/j.jad.2020.03.171. Epub 2020 Apr 18.
Compare longitudinal trajectories of youth with Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV Bipolar Disorder (BD), grouped at baseline by presence/absence of increased energy during their worst lifetime mood episode (required for DSM-5).
Participants from the parent Course and Outcome of Bipolar Youth study (N = 446) were assessed utilizing The Schedule for Affective Disorders and Schizophrenia for School-Age Children (KSADS), KSADS Mania Rating Scale (KMRS), and KSADS Depression Rating Scale (KDRS). Youth were grouped at baseline into those with increased energy (meeting DSM-5 Criteria A for mania) vs. without increased energy (meeting DSM-IV, but not DSM-5, Criteria A for mania), for those who had worst lifetime mood episode recorded (n = 430). Youth with available longitudinal data had the presence/absence of increased energy measured, as well as psychiatric symptomatology/clinical outcomes (evaluated via the Adolescent Longitudinal Interval Follow-Up Evaluation), at each follow-up for 12.5 years (n = 398).
At baseline, the increased energy group (based on endorsed increased energy during worst lifetime mood episode; 86% of participants) vs. the without increased energy group, were more likely to meet criteria for BD-I and BD Not Otherwise Specified, had higher KMRS/KDRS total scores, and displayed poorer family/global psychosocial functioning. However, frequency of increased energy between groups was comparable after 5 years, and no significant group differences were found on clinical/psychosocial functioning outcomes after 12.5 years.
Secondary data limited study design; groupings were based on one time point.
Results indicate no clinically relevant longitudinal group differences.
比较符合 DSM-5 诊断标准（即有或无一生中最严重的躁狂发作时精力增加）的青少年双相障碍（BD）患者的纵向轨迹，这些患者在基线时根据一生中最严重的躁狂发作时是否存在精力增加进行分组。
来自父母的 Course 和 Outcome of Bipolar Youth 研究（N=446）的参与者使用儿童青少年心境障碍和精神分裂症的诊断性定式检查（KSADS）、KSADS 躁狂评定量表（KMRS）和 KSADS 抑郁评定量表（KDRS）进行评估。将基线时有精力增加（符合 DSM-5 躁狂症标准 A）的患者与无精力增加（符合 DSM-IV，但不符合 DSM-5 的躁狂症标准 A）的患者进行分组，这些患者有一生中最严重的躁狂发作记录（n=430）。有可用纵向数据的患者在 12.5 年的每次随访中测量有无精力增加，以及精神病症状/临床结局（通过青少年纵向间隔随访评估）（n=398）。
基线时，精力增加组（根据一生中最严重的躁狂发作时精力增加的自我报告；86%的参与者）比无精力增加组更有可能符合 BD-I 和 BD 未特指型的标准，KMRS/KDRS 总分更高，家庭/全球社会心理功能更差。然而，两组之间的精力增加频率在 5 年后相似，在 12.5 年后的临床/社会心理功能结局上没有发现显著的组间差异。
二次数据限制了研究设计；分组基于一个时间点。
结果表明没有临床上相关的纵向组间差异。
