Aymerich Clàudia, Bullock Edward, Rowe Savannah M B, Catalan Ana, Salazar de Pablo Gonzalo
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain.
JAACAP Open. 2024 Apr 24;3(1):42-55. doi: 10.1016/j.jaacop.2024.02.009. eCollection 2025 Mar.
Bipolar disorder (BD) in childhood and adolescence is associated with aggressive behaviors, which might be common and in turn associated with poor clinical outcomes. This is the first systematic review to provide a comprehensive view of the current status of the knowledge about aggressive behaviors in youth with BD.
We conducted a PRISMA-compliant systematic review of studies investigating aggressive behaviors in children and adolescents with BD (PROSPERO: CRD42023431674). A systematic multi-step literature search was performed on PubMed and the Web of Science. Literature search and data extraction were carried out independently. We provided a systematic synthesis of the findings from the included studies We assessed risk of bias using a modified version of the Newcastle-Ottawa Scale for cross-sectional and cohort studies.
Of the 2,277 identified records 35 were included; mean age was 12.4 years, and 57.1% were male individuals. 7 studies reported on the prevalence of aggressive behavior among BD children and adolescent population, with 5 of them reporting a prevalence of over 69.0%. Aggressive behaviors were more common in children and adolescents with BD than in those with ADHD or depression. Aggressive behaviors were associated with borderline personality disorder features and poor family functioning. Valproic acid received empirical support for its efficacy in reducing aggressive behavior in BD.
Aggressive behaviors are prevalent among youth with BD and warrant clinical attention and specific evidence-based management. Further research on prognostic factors and psychosocial interventions evaluated prospectively is required.
DIVERSITY & INCLUSION STATEMENT: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.
儿童和青少年双相情感障碍（BD）与攻击行为相关，攻击行为可能很常见，进而与不良临床结局相关。这是第一项系统评价，旨在全面呈现有关BD青少年攻击行为的现有知识状况。
我们按照PRISMA标准对调查BD儿童和青少年攻击行为的研究进行了系统评价（国际前瞻性系统评价注册平台：CRD42023431674）。在PubMed和科学网进行了多步骤系统文献检索。文献检索和数据提取独立进行。我们对纳入研究的结果进行了系统综合。我们使用纽卡斯尔-渥太华量表的修改版评估横断面研究和队列研究的偏倚风险。
在2277条检索到的记录中，纳入了35条；平均年龄为12.4岁，57.1%为男性。7项研究报告了BD儿童和青少年人群中攻击行为的患病率，其中5项报告患病率超过69.0%。BD儿童和青少年的攻击行为比患有注意力缺陷多动障碍（ADHD）或抑郁症的儿童和青少年更常见。攻击行为与边缘型人格障碍特征和不良家庭功能相关。丙戊酸在降低BD攻击行为方面的疗效得到了经验支持。
攻击行为在BD青少年中普遍存在，值得临床关注和基于证据的特定管理。需要对预后因素和前瞻性评估的心理社会干预措施进行进一步研究。
本文的一位或多位作者自我认定为科学领域中一个或多个历史上代表性不足的种族和/或族裔群体的成员。本文的一位或多位作者自我认定为科学领域中一个或多个历史上代表性不足的性取向和/或性别群体的成员。本文的一位或多位作者自我认定为残疾人士。我们积极努力促进作者群体中的性别平衡。我们积极努力促进作者群体中纳入科学领域历史上代表性不足的种族和/或族裔群体。
