Lewinsohn P M, Klein D N, Seeley J R
Oregon Research Institute, Eugene 97403-1983, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Apr;34(4):454-63.
The purpose of this study was to examine the prevalence, clinical characteristics, and mental health treatment services utilization of adolescents with bipolar disorders and manic symptoms.
Structured diagnostic interviews were administered to a representative community sample of 1,709 older adolescents (aged 14 through 18 years).
The lifetime prevalence of bipolar disorders (primarily bipolar II disorder and cyclothymia) was approximately 1%. An additional 5.7% of the sample reported having experienced a distinct period of abnormally and persistently elevated, expansive, or irritable mood even though they never met criteria for bipolar disorder ("core positive" subjects). The rate of manic symptoms in these subjects was similar to that reported in clinical samples, and the course of bipolar disorder was relatively chronic. Compared with adolescents with a history of major depression (n = 316) and a "never mentally ill" group (n = 845), the bipolar and core positive subjects both exhibited significant functional impairment and high rates of comorbidity (particularly with anxiety and disruptive behavior disorders), suicide attempts, and mental health services utilization.
These data highlight the clinical and public health significance of even the milder and subthreshold cases of bipolar disorder in adolescence.
本研究旨在调查患有双相情感障碍及躁狂症状的青少年的患病率、临床特征及心理健康治疗服务的使用情况。
对1709名年龄较大的青少年（14至18岁）的代表性社区样本进行结构化诊断访谈。
双相情感障碍（主要为双相II型障碍和环性心境障碍）的终生患病率约为1%。另有5.7%的样本报告称经历过一段明显的异常且持续高涨、易激惹或烦躁的情绪期，尽管他们从未符合双相情感障碍的诊断标准（“核心阳性”受试者）。这些受试者的躁狂症状发生率与临床样本中报告的相似，且双相情感障碍病程相对呈慢性。与有重度抑郁病史的青少年（n = 316）和“从未患精神疾病”组（n = 845）相比，双相情感障碍组和核心阳性组均表现出显著的功能损害、高共病率（尤其是与焦虑和破坏行为障碍）、自杀未遂及心理健康服务利用率。
这些数据凸显了青春期双相情感障碍即使是较轻和阈下病例的临床及公共卫生意义。
