Journal of the Korean Academy of Child and Adolescent Psychiatry

대한소아청소년정신의학회 (Korean Academy of Child and Adolescent Psychiatry)
권호 표지
DOI QR코드

DOI QR Code

Clinical Characteristics of Pediatric Bipolar Disorder by Subtype in a Korean Inpatient Sample

  • Park, Subin (Department of Psychiatry, Seoul National Hospital) ;
  • Cho, Soo-Churl (Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine) ;
  • Kwon, Ohyang (Department of Psychiatry, Hyewon St. Mary's Hospital) ;
  • Bae, Jeong-Hoon (Department of Neuropsychiatry, Bongseng Memorial Hospital) ;
  • Kim, Jae-Won (Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine) ;
  • Shin, Min-Sup (Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine) ;
  • Yoo, Hee-Jeong (Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine) ;
  • Kim, Bung-Nyun (Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine)
  • 투고 : 2015.04.27
  • 심사 : 2015.06.05
  • 발행 : 2015.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives : We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). Methods : The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. Results : Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. Conclusion : Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.

키워드

참고문헌

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-4. 4th ed. Washington, DC: American Psychiatric Association;1994.
  2. Akiskal HS. The prevalent clinical spectrum of bipolar disorders: beyond DSM-IV. J Clin Psychopharmacol 1996;16(2 Suppl 1):4S-14S. https://doi.org/10.1097/00004714-199604001-00002
  3. Faedda GL, Baldessarini RJ, Glovinsky IP, Austin NB. Pediatric bipolar disorder: phenomenology and course of illness. Bipolar Disord 2004;6:305-313. https://doi.org/10.1111/j.1399-5618.2004.00128.x
  4. Findling RL, Gracious BL, McNamara NK, Youngstrom EA, Demeter CA, Branicky LA, et al. Rapid, continuous cycling and psychiatric co-morbidity in pediatric bipolar I disorder. Bipolar Disord 2001;3:202-210. https://doi.org/10.1034/j.1399-5618.2001.30405.x
  5. Geller B, Sun K, Zimerman B, Luby J, Frazier J, Williams M. Complex and rapid-cycling in bipolar children and adolescents: a preliminary study. J Affect Disord 1995;34:259-268. https://doi.org/10.1016/0165-0327(95)00023-G
  6. Masi G, Perugi G, Toni C, Millepiedi S, Mucci M, Bertini N, et al. The clinical phenotypes of juvenile bipolar disorder: toward a validation of the episodic-chronic-distinction. Biol Psychiatry 2006;59:603-610. https://doi.org/10.1016/j.biopsych.2005.08.034
  7. Carlson GA, Pine DS, Nottelmann E, Leibenluft E. Defining subtypes of childhood bipolar disorder: response and commentary. J Am Acad Child Adolesc Psychiatry 2004;43:3-4. https://doi.org/10.1097/00004583-200401000-00003
  8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association;2013.
  9. Masi G, Perugi G, Millepiedi S, Mucci M, Pari C, Pfanner C, et al. Clinical implications of DSM-IV subtyping of bipolar disorders in referred children and adolescents. J Am Acad Child Adolesc Psychiatry 2007;46:1299-1306. https://doi.org/10.1097/chi.0b013e3180f62eba
  10. Birmaher B, Axelson D, Strober M, Gill MK, Valeri S, Chiappetta L, et al. Clinical course of children and adolescents with bipolar spectrum disorders. Arch Gen Psychiatry 2006;63:175-183. https://doi.org/10.1001/archpsyc.63.2.175
  11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-4-TR. 4th ed., text revision. Washington, DC: American Psychiatric Association;2000.
  12. Park K, Yoon J, Park H. The Manual of Korean Educational Development Institute-Wechsler Intelligence Scale for Children-Revised. Seoul: Korean Educational Development Institute;1991.
  13. Bora E, Yucel M, Pantelis C. Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. J Affect Disord 2009;113:1-20. https://doi.org/10.1016/j.jad.2008.06.009
  14. Joseph MF, Frazier TW, Youngstrom EA, Soares JC. A quantitative and qualitative review of neurocognitive performance in pediatric bipolar disorder. J Child Adolesc Psychopharmacol 2008;18:595-605. https://doi.org/10.1089/cap.2008.064
  15. Schenkel LS, West AE, Jacobs R, Sweeney JA, Pavuluri MN. Cognitive dysfunction is worse among pediatric patients with bipolar disorder Type I than Type II. J Child Psychol Psychiatry 2012;53:775-781. https://doi.org/10.1111/j.1469-7610.2011.02519.x
  16. Biederman J, Russell R, Soriano J, Wozniak J, Faraone SV. Clinical features of children with both ADHD and mania: does ascertainment source make a difference? J Affect Disord 1998;51:101-112. https://doi.org/10.1016/S0165-0327(98)00177-3
  17. Sachs GS, Baldassano CF, Truman CJ, Guille C. Comorbidity of attention deficit hyperactivity disorder with early- and late-onset bipolar disorder. Am J Psychiatry 2000;157:466-468. https://doi.org/10.1176/appi.ajp.157.3.466
  18. Wozniak J, Spencer T, Biederman J, Kwon A, Monuteaux M, Rettew J, et al. The clinical characteristics of unipolar vs. bipolar major depression in ADHD youth. J Affect Disord 2004;82 Suppl 1:S59-S69. https://doi.org/10.1016/j.jad.2004.05.013
  19. Dilsaver SC, Henderson-Fuller S, Akiskal HS. Occult mood disorders in 104 consecutively presenting children referred for the treatment of attention-deficit/hyperactivity disorder in a community mental health clinic. J Clin Psychiatry 2003;64:1170-1176; quiz, 1274-1276. https://doi.org/10.4088/JCP.v64n1005