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Prospectively ascertained mania and hypomania among young adults with child- and adolescent-onset bipolar disorder
Bipolar Disorders ( IF 5.4 ) Pub Date : 2020-12-19 , DOI: 10.1111/bdi.13034
Danella M Hafeman 1 , Tina R Goldstein 1 , Michael Strober 2 , John Merranko 1 , Mary Kay Gill 1 , Fangzi Liao 1 , Rasim S Diler 1 , Neal D Ryan 1 , Benjamin I Goldstein 3 , David A Axelson 4 , Martin B Keller 5, 6 , Jeffrey I Hunt 5, 7 , Heather Hower 5, 8, 9 , Lauren M Weinstock 5, 6 , Shirley Yen 5, 10 , Boris Birmaher 1
Affiliation  

While adults with bipolar disorder (BD) often report symptoms starting in childhood, continuity of mania and/or hypomania (mania/hypomania) from childhood to adulthood has been questioned. Using longitudinal data from the Course and Outcome of Bipolar Youth (COBY) study, we assessed threshold mania/hypomania in young adults who manifested BD as youth. Methods: COBY is a naturalistic, longitudinal study of 446 youth with BD (84% recruited from outpatient clinics), 7–17 years old at intake, and over 11 years of follow-up. Focusing on youth with BD-I/II (n = 297), we examined adult mania/hypomania risk (>18 years old; mean 7.9 years of follow-up) according to child (<13 years old) versus adolescent (13–17 years old) onset. We next used penalized regression to test demographic and clinical predictors of young adult mania/hypomania. Results: Most participants (64%) had child-onset mania/hypomania, 57% of whom also experienced mania/hypomania in adolescence. Among those who experienced an episode in adolescence, over 40% also had mania/hypomania during adulthood; the risk did not differ according to child versus adolescent onset. In contrast, 7% with mania/hypomania in childhood, but not adolescence, experienced mania/hypomania in adulthood. Family history (of mania and suicide attempts) predicted mania/hypomania in young adulthood (p-values <0.05); age of onset was not a significant predictor. Among participants with no mania/hypomania during adulthood, 53% (105/198) still experienced subthreshold manic episodes. Discussion: We find substantial continuity across developmental stage indicating that, in this carefully characterized sample, children who experience mania/hypomania—particularly those who also experience mania/hypomania in adolescence—are likely to experience mania/hypomania in young adulthood.

中文翻译:

前瞻性确定患有儿童和青少年双相情感障碍的年轻人的躁狂和轻躁狂

虽然患有双相情感障碍 (BD) 的成年人经常报告从儿童期开始的症状,但从儿童期到成年期的躁狂和/或轻躁狂(躁狂/轻躁狂)的连续性受到质疑。使用来自双相青年 (COBY) 研究的过程和结果的纵向数据,我们评估了表现为青年 BD 的年轻人的阈值躁狂/轻躁狂。方法:COBY 是一项自然纵向研究,对 446 名 BD 青年(84% 从门诊招募)、入学时 7-17 岁和超过 11 年的随访。关注 BD-I/II 型青年(n = 297),我们根据儿童(<13 岁)与青少年(13- 17 岁)发病。接下来,我们使用惩罚回归来测试年轻成人躁狂/轻躁狂的人口统计学和临床​​预测因素。结果:大多数参与者 (64%) 患有儿童期躁狂症/轻躁狂症,其中 57% 的人在青春期也经历过躁狂症/轻躁狂症。在那些经历过青春期发作的人中,超过 40% 的人在成年期也有躁狂/轻躁狂;儿童和青少年发病的风险没有差异。相比之下,7% 在儿童期患有躁狂症/轻躁狂症,但在青春期没有,在成年期经历过躁狂症/轻躁狂症。家族史(躁狂和自杀未遂)预示着青年期的躁狂/轻躁狂(在成年期经历过躁狂症/轻躁狂症。家族史(躁狂和自杀未遂)预示着青年期的躁狂/轻躁狂(在成年期经历过躁狂症/轻躁狂症。家族史(躁狂和自杀未遂)预示着青年期的躁狂/轻躁狂(p值<0.05);发病年龄不是一个重要的预测因素。在成年期没有躁狂/轻躁狂的参与者中,53% (105/198) 仍然经历过阈下躁狂发作。讨论:我们发现整个发育阶段的连续性表明,在这个经过仔细表征的样本中,患有躁狂症/轻躁狂症的儿童——尤其是那些在青春期也经历过躁狂症/轻躁狂症的儿童——很可能在青年期经历躁狂症/轻躁狂症。
更新日期:2020-12-19
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