OBJECTIVE This study aims to document rates of sexual activity among youth with bipolar spectrum disorder (BD) and to examine demographic and clinical factors associated with first sexual activity and sexual risk behavior during follow-up. METHOD The sample was drawn from the Course and Outcome of Bipolar Youth (COBY) study of 413 youth 7 to 17 years at baseline who met criteria for bipolar spectrum disorder according to the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Psychiatric symptoms during follow-up were assessed using the Adolescent Longitudinal Interview Follow-Up Evaluation (ALIFE). Sexual behavior and level of sexual risk (e.g., unprotected sex, multiple partners, and/or partners with known sexually transmitted infections) were assessed by trained evaluators using the ALIFE Psychosocial Functioning Scale. Analyses were conducted in relation to first sexual behavior during follow-up and then to subsequent sexual behaviors (mean 9.7 years, standard deviation 3.2). RESULTS Sexually active COBY youth (n = 292 of 413; 71%) were more likely females, using substances, and not living with both parents. Consistent with findings among healthy youth, earlier first sexual activity in the sample was significantly associated with low socioeconomic status, female sex, comorbid disruptive behavior disorder, and substance use. As with healthy youth, sexual risk behavior during follow-up was significantly associated with non-Caucasian race, low socioeconomic status, substance use, and history of sexual abuse. Of those COBY youth who were sexually active, 11% reported sexual assault or abuse, 36% reported becoming pregnant (or the significant other becoming pregnant), and 15% reported having at least 1 abortion (or the significant other having an abortion) during follow-up. Hypomanic symptoms during follow-up were temporally associated with the greatest risk for sexual risk behavior. CONCLUSION Demographic and clinical factors could help identify youth with bipolar spectrum disorder at significantly greatest risk for sexual activity and sexual risk behavior. Attending to sexual risk behaviors in this population is warranted.

中文翻译：

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双相情感障碍青少年的性危险行为：识别人口和临床危险因素。


目的 本研究旨在记录双相情感障碍 (BD) 青少年的性活动率，并检查与首次性活动和随访期间性危险行为相关的人口统计和临床因素。方法 样本取自双相情感障碍青少年的过程和结果 (COBY) 研究，该研究对 413 名 7 至 17 岁青少年进行了研究，这些青少年在基线时符合《学龄儿童情感障碍和精神分裂症表》中双相情感障碍标准。使用青少年纵向访谈随访评估（ALIFE）评估随访期间的精神症状。性行为和性风险水平（例如，无保护性行为、多个伴侣和/或患有已知性传播感染的伴侣）由经过培训的评估员使用 ALIFE 心理社会功能量表进行评估。对随访期间的首次性行为和随后的性行为进行了分析（平均 9.7 年，标准差 3.2）。结果 性活跃的 COBY 青少年（n = 413 人中的 292 人；71%）更有可能是女性，她们使用药物，并且不与父母同住。与健康青少年的研究结果一致，样本中较早的首次性行为与社会经济地位低、女性、共病破坏性行为障碍和药物滥用显着相关。与健康青少年一样，随访期间的性危险行为与非白人种族、社会经济地位较低、药物使用和性虐待史显着相关。 在性活跃的 COBY 青少年中，11% 的人报告性侵犯或性虐待，36% 的人报告怀孕（或另一半怀孕），15% 的人报告至少有 1 次堕胎（或另一半堕胎）后续行动。随访期间的轻躁狂症状暂时与危险性行为的最大风险相关。结论 人口统计和临床因素可以帮助识别患有躁郁症谱系障碍的青少年，其性活动和危险性行为的风险显着最大。有必要关注这一人群的性危险行为。