Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA.
J Psychiatr Res. 2022 Jul;151:667-675. doi: 10.1016/j.jpsychires.2022.04.008. Epub 2022 May 3.
To examine patterns of remission of pediatric bipolar I (BP-I) disorder attending to syndromatic, symptomatic, and functional outcomes from childhood to adolescent and young adult years.
We analyzed data from a six-year prospective follow-up study of youths aged 6-17 years with BP-I disorder. Subjects were comprehensively assessed at baseline and subsequently at four, five, and six years thereafter. Assessments included structured diagnostic interviews and measures of psychosocial and educational functioning. Patterns of remission were calculated attending to whether syndromatic, symptomatic, and functional remission were achieved.
Kaplan-Meier failure functions revealed that the probability of functional recovery from pediatric BP-I disorder was very low. Of the 88 youths assessed, only 6% (N = 5) of the sample were euthymic with normal functioning during the year prior to their last follow-up assessment (average follow-up time = 5.8 ± 1.8 years).
These results provide compelling evidence of the high level of persistence of pediatric BP-I disorder. Symptomatic and functional remission were uncommon and most subjects continued to demonstrate high morbidity into late adolescence and early adulthood.
探讨儿科双相 I 型（BP-I）障碍在儿童期到青少年和青年期的综合征、症状和功能结局方面缓解的模式。
我们分析了一项为期六年的前瞻性随访研究的数据，该研究对象为 6-17 岁的 BP-I 障碍青少年。在基线时以及随后的四年、五年和六年后对受试者进行了全面评估。评估包括结构化诊断访谈和心理社会及教育功能的测量。通过评估是否达到综合征、症状和功能缓解来计算缓解模式。
Kaplan-Meier 失败函数显示，从儿科 BP-I 障碍中恢复功能的可能性非常低。在接受评估的 88 名青少年中，只有 6%（N=5）的样本在最后一次随访评估前一年表现出正常功能的缓解（平均随访时间=5.8±1.8 年）。
这些结果提供了令人信服的证据，表明儿科 BP-I 障碍的持续时间很高。症状和功能缓解并不常见，大多数患者在青少年后期和成年早期继续表现出高发病率。
