Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey.
Diyarbakır State Hospital, Diyarbakır, Turkey.
Clin Child Psychol Psychiatry. 2023 Oct;28(4):1266-1278. doi: 10.1177/13591045221125331. Epub 2022 Sep 2.
We aimed to investigate the characteristics of adolescents with Bipolar disorder-I with irritability and agitation (Mania+IA) compared to those without irritability and agitation (Mania-IA) in a multi-center representative sample.
Data of 145 patients from three tertiary-care inpatient units between 2016 and 2021 were obtained. Psychomotor agitation was defined as a score of ≥3 on the YMRS "Increased Motor Activity--Energy" item, irritability as a score of ≥4 on the YMRS 'irritability' item, and severity anchors of speech and thought disturbance on the YMRS '6 and 7' items.
Previous manic episodes ( = 0.013), involuntary hospitalization ( = 0.006), psychotic features ( = 0.001), formal thought disorder ( = 0.010) and aggressive/disruptive behavior ( = 0.021) were more frequent in the Mania+IA group. Conversely, depressive episodes ( = 0.006) and family history of depression ( = 0.024) were more frequent in the Mania-IA group. The Mania+IA had poorer functioning at the time of discharge.
Irritability and agitation were closely related to complications, psychotic symptoms and thought disorder. Assessment and monitoring of psychomotor agitation and irritability may help child and adolescent psychiatrists to predict clinical difficulties and appropriate interventions.
本研究旨在多中心代表性样本中，调查伴有易激惹和激越（躁狂+IA）的青少年双相障碍 I 型与不伴有易激惹和激越（躁狂-IA）的青少年患者的特征。
本研究收集了 2016 年至 2021 年间三家三级护理住院部的 145 名患者的数据。精神运动激越定义为 YMRS“增加的运动活动-能量”项目中得分≥3，易激惹定义为 YMRS“易激惹”项目中得分≥4，以及 YMRS“6 和 7”项目中言语和思维障碍的严重程度标准。
在躁狂+IA 组中，先前的躁狂发作（ = 0.013）、非自愿住院（ = 0.006）、精神病特征（ = 0.001）、思维形式障碍（ = 0.010）和攻击/破坏性行为（ = 0.021）更为常见。相反，在躁狂-IA 组中，抑郁发作（ = 0.006）和抑郁家族史（ = 0.024）更为常见。躁狂+IA 组在出院时的功能较差。
易激惹和激越与并发症、精神病症状和思维障碍密切相关。评估和监测精神运动激越和易激惹可能有助于儿童和青少年精神科医生预测临床困难并进行适当干预。
