West S A, Strakowski S M, Sax K W, Minnery K L, McElroy S L, Keck P E
Department of Psychiatry, University of Cincinnati College of Medicine, OH, USA.
Psychopharmacol Bull. 1995;31(2):347-51.
The frequency of attention-deficit hyperactivity disorder (ADHD) was assessed in 20 adolescents with DSM-III-R bipolar disorder hospitalized for the treatment of acute mania. Thirteen (65%) patients met DSM-III-R criteria for ADHD. Patients who met criteria for both disorders were more likely to be Caucasian and male, and to have mixed rather than pure mania. Patients with ADHD also had a higher mean total Young Mania Rating Scale score and lower serum thyroxine concentrations than patients with bipolar disorder alone. These results suggest that prior histories of ADHD or ADHD symptoms may be common in adolescents hospitalized for mania, and that patients with both disorders may have more severe manic symptoms than patients with mania alone. These findings may have important implications, especially in determining the optimal pharmacologic treatment of patients who meet criteria for both disorders, because standard treatments for ADHD and bipolar disorder have been assumed to exert opposing effects.
对20名因急性躁狂发作住院治疗的符合《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）双相情感障碍标准的青少年进行了注意力缺陷多动障碍（ADHD）的发生率评估。其中13名（65%）患者符合DSM-III-R的ADHD标准。同时符合两种疾病标准的患者更可能是白种人和男性，且更倾向于混合性而非单纯性躁狂。与仅患有双相情感障碍的患者相比，患有ADHD的患者平均杨氏躁狂评定量表总分更高，血清甲状腺素浓度更低。这些结果表明，在因躁狂发作住院的青少年中，ADHD既往史或ADHD症状可能很常见，且同时患有两种疾病的患者可能比仅患有躁狂症的患者有更严重的躁狂症状。这些发现可能具有重要意义，特别是在确定符合两种疾病标准的患者的最佳药物治疗方案时，因为ADHD和双相情感障碍的标准治疗方法被认为具有相反的作用。
