소아청소년 양극성 장애의 임상 양상 및 약물치료
Clinical Manifestation and Psychopharmacotherpy of Pediatric Bipolar Disorder
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초록
Pediatric bipolar disorder(BD) is one of the significant psychiatric health problems, which begins in childhood, has chronic persisting clinical course and leads impairs academic, occupational and legal problems of the patients. Fortunately, there has been increasing recognition of pediatric bipolar disorder during the past 10 years, even there are still controversy about clinical features and diagnosis. The clinical presentation of pediatric BD is greatly different to classic BD, relatively higher percentage of mixed, rapid cycling subtypes, not episodic and chronic lasting nature. In addition, pediatric BD has many comorbid psychiatric conditions such as attention deficit hyperactivity disorder, anxiety disorder and that makes more difficult to treat the patients with pediatric BD. To reduce confusion about diagnosis, the National Institute of Mental Health Research Roundtable divided pediatric BD into narrow and broad phenotype. 1) Given the paucity of medication trial studies of pediatric BD, no psychotrophic medications have been approved by U.S. Food and Drug Administration, except lithium. There have been a few open trials and retrospective chart reviews on the efficacy and side effects of mood stabilizers, anticonvulsants and atypical antipsychotics. More short and long-term randomized, double blind, well controlled trials of medication for pediatric BD are needed.
Abstract
Pediatric bipolar disorder(BD) is one of the significant psychiatric health problems, which begins in childhood, has chronic persisting clinical course and leads impairs academic, occupational and legal problems of the patients. Fortunately, there has been increasing recognition of pediatric bipolar disorder during the past 10 years, even there are still controversy about clinical features and diagnosis. The clinical presentation of pediatric BD is greatly different to classic BD, relatively higher percentage of mixed, rapid cycling subtypes, not episodic and chronic lasting nature. In addition, pediatric BD has many comorbid psychiatric conditions such as attention deficit hyperactivity disorder, anxiety disorder and that makes more difficult to treat the patients with pediatric BD. To reduce confusion about diagnosis, the National Institute of Mental Health Research Roundtable divided pediatric BD into narrow and broad phenotype. 1) Given the paucity of medication trial studies of pediatric BD, no psychotrophic medications have been approved by U.S. Food and Drug Administration, except lithium. There have been a few open trials and retrospective chart reviews on the efficacy and side effects of mood stabilizers, anticonvulsants and atypical antipsychotics. More short and long-term randomized, double blind, well controlled trials of medication for pediatric BD are needed.