OBJECTIVE The Course and Outcome of Bipolar Youth study found that children and adolescents with bipolar spectrum disorders followed 1 of 4 distinct mood trajectories over 8 years of follow-up, with as many as 25% of participants showing a predominantly euthymic course. We evaluated whether similar patterns of illness course are observed in adolescents with bipolar I and II disorder who participated in a 2-year clinical trial. METHOD A total of 144 adolescents with bipolar I or II disorder, identified shortly after a mood episode, were assessed over a 2-year period. Participants were randomly assigned to one of 2 psychosocial family treatments during the first 9 months of the study, and pharmacotherapy was provided throughout the 2 years. Using latent class growth analyses, we classified participants into distinct courses of illness based on mood ratings collected over the 2 years. We examined demographic and illness variables as predictors of these course classifications. RESULTS Latent class growth analyses indicated four mood trajectories: "predominantly euthymic" (29.9% of sample), "ill with significantly improving course" (11.1%), "moderately euthymic" (26.4%), and "ill with moderately improving course" (32.6%). Adolescents in these classes were euthymic 77.7%, 53.6%, 44.1%, and 18.6% of the weeks of follow-up, respectively. Psychosocial treatment condition and baseline medication exposure were not associated with trajectories. However, youth with more severe baseline depressive symptoms, suicidality, lower quality of life scores, and minority race/ethnicity had more symptomatic courses of illness over time. CONCLUSION A substantial proportion (25%-30%) of youth with bipolar I or II disorder maintain euthymic states over extended periods of follow-up. Identifying youth who are more and less likely to remain stable over time may help guide psychosocial and pharmacological treatments after an illness episode. CLINICAL TRIAL REGISTRATION INFORMATION Effectiveness of Family-Focused Treatment Plus Pharmacotherapy for Bipolar Disorder in Adolescents; https://clinicaltrials.gov/; NCT00332098.

中文翻译：

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对患有双相情感障碍的青少年的情绪症状轨迹进行分类。

目标 双相青少年的过程和结果研究发现，在 8 年的随访中，患有双相谱系障碍的儿童和青少年遵循 4 种不同情绪轨迹中的一种，多达 25% 的参与者表现出主要是情绪正常的过程。我们评估了在参加为期 2 年的临床试验的双相 I 和 II 型障碍青少年中是否观察到类似的病程模式。方法 在 2 年期间对总共 144 名患有双相 I 或 II 型障碍的青少年进行了评估，这些青少年在情绪发作后不久被确定。在研究的前 9 个月，参与者被随机分配到 2 种心理社会家庭治疗中的一种，并在 2 年内提供药物治疗。使用潜在类增长分析，我们根据 2 年来收集的情绪评级将参与者分为不同的疾病进程。我们检查了人口统计和疾病变量作为这些课程分类的预测因素。结果 潜在类别增长分析表明四种情绪轨迹：“主要是正常的”（样本的 29.9%）、“病程显着改善”（11.1%）、“中度正常”（26.4%）和“病程适度改善” (32.6%)。这些班级的青少年在随访的几周内分别为 77.7%、53.6%、44.1% 和 18.6%。心理社会治疗条件和基线药物暴露与轨迹无关。然而，有更严重的基线抑郁症状、有自杀倾向、生活质量得分较低、随着时间的推移，少数种族/族裔的症状性病程更多。结论 相当一部分（25%-30%）患有双相 I 或 II 型障碍的青少年在长期随访期间保持心境正常。确定随着时间推移越来越不可能保持稳定的青年可能有助于指导疾病发作后的心理社会和药物治疗。临床试验注册信息 以家庭为中心的治疗加药物治疗青少年双相情感障碍的有效性；https://clinicaltrials.gov/；NCT00332098。确定随着时间推移越来越不可能保持稳定的青年可能有助于指导疾病发作后的心理社会和药物治疗。临床试验注册信息 以家庭为中心的治疗加药物治疗青少年双相情感障碍的有效性；https://clinicaltrials.gov/；NCT00332098。确定随着时间推移越来越不可能保持稳定的青年可能有助于指导疾病发作后的心理社会和药物治疗。临床试验注册信息 以家庭为中心的治疗加药物治疗青少年双相情感障碍的有效性；https://clinicaltrials.gov/；NCT00332098。