tailieunhanh - TREATMENT OF BIPOLAR DISORDER IN CHILDREN AND ADOLESCENTS - PART 8

Dân số đã nhận được sự xem xét kỹ lưỡng nhất là có nguy cơ cao cho sự phát triển rối loạn lưỡng cực đã được con cái của cha mẹ với rối loạn lưỡng cực ("lưỡng cực con"). Những đứa trẻ này tự nhiên có nguy cơ cao di truyền bản chất của rối loạn lưỡng cực. Nghiên cứu cắt ngang đương đại của con cái tại Hoa Kỳ cho thấy khoảng 50% | 288 COMORBID DISORDERS AND SPECIAL POPULATIONS from having manic episodes With these questions unanswered many may feel that it is too early to discuss preventative intervention especially when the phenomenological presentation and course of childhood bipolar disorder is still unclear and in debate Carlson 2005 . The ultimate responsibility for a child however remains with the parent and parents who themselves suffer from bipolar disorder have repeatedly told me that they do not want their child to go through what they did. POPULATIONS AT HIGH RISK FOR BIPOLAR DISORDER The population that has received the most scrutiny as being at high risk for bipolar disorder development has been offspring of parents with bipolar disorder bipolar offspring . These children are naturally at risk due to the highly heritable nature of bipolar disorder. Contemporary cross-sectional studies of such offspring in the United States reveal that approximately 50 have some psychiatric disorder with 14-50 already having bipolar spectrum disorders Chang Steiner 2003 DelBello Geller 2001 . Of greater interest are the approximately 25 with attention-deficit hyperactivity disorder ADHD and 20 with unipolar depression Chang Steiner Ketter 2000 Henin et al. 2005 . Why are these rates five times greater than expected in the general population It is likely that a subset of these children will go on to develop bipolar disorder. For example prospective studies have found the risk of developing bipolar disorder to be 30 in a prepubertal child with major depressive disorder MDD Geller Fox Clark 1994 . The risk would appear to be greater if that child has a first-degree relative with bipolar disorder but this quantification has not yet been done. Similarly ADHD is now recognized as the earliest sign of bipolar disorder in an early-onset subtype of bipolar disorder Faraone Bieder-man Mennin Wozniak Spencer 1997 Sachs Baldassano Truman Guille 2000 and up to 28 of children with ADHD may eventually develop .

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