Comparison of Symptoms of Pediatric Bipolar Disorder in the Manic Phase and Attention Deficit and Hyperactivity Disorder

摘要

Objectives: The clinical presentation of Bipolar Disorder (BD) in adults often has an episodic course. However, pediatric onset BD often presents with higher rates of mixed episodes, rapid cycling, and co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) than adults with BD. The aim of this study is to describe the clinical characteristics of pediatric onset BD in a Turkish sample and to compare these characteristics with children with a diagnosis of Attention Deficit and Hyperactivity Disorder (ADHD).Methods: A total of 19 child or adolescent patients diagnosed with BD in the manic state and 19 child or adolescent patients diagnosed with ADHD based on DSM-IV criteria were included in the study. The children were analyzed in terms of age of onset, symptoms, and comorbidity. Subsequently, both groups were compared in terms of symptoms of BD according to the Child Mania Rating Scale.Results: ?rritable mood (94%), rapid mood swings (89%), delusions (94%), auditory (63%) and visual hallucinations (47%) were detected statistically more commonly in the bipolar disorder patients. There were no significant differences between the two groups in terms of hyperactivity, distractibility, and irritability.Conclusion: Children and adolescents with BD often present with higher rates of rapid mood swings, irritable mood, and psychotic features. However, irritability does not seem to be a specific symptom for pediatric BD.?ZETAma?: Eri?kin bipolar bozuklu?u ?o?unlukla epizodik seyir g?stermektedir. Ancak pediatrik bipolar bozuklukta karma epizodlar ve h?zl? d?ngü eri?kin bipolar bozuklu?a g?re daha s?k g?rülen durumlard?r ve beraberinde Dikkat Eksikli?i ve Hiperaktivite Bozuklu?u (DEHB) tan?s? s?kl?kla bulunmaktad?r. Bu ?al??man?n amac? pediatrik bipolar bozukluk tan?s? alm?? bir grup hastada bu bozuklu?un klinik karakteristik ?zelliklerini belirlemek ve bu ?zellikleri DEHB tan?s? olan hastalar ile kar??la?t?rmakt?r.Y?ntem: ?rneklem DSM-IV tan? kritelerine g?re pediatrik bipolar bozukluk manik d?nem ve DEHB tan?lar? konulmu? olan 19′ar ?ocuk veya ergen hastadan olu?maktad?r. Hastal???n ba?lama ya??, belirtiler ve e? tan?lar analiz edilmi?tir. Daha sonra iki grup Child Mania Rating Scale ile belirlenmi? olan hastal?k belirtileri bak?m?ndan kar??la?t?r?lm??t?r.Bulgular: ?rritabl duygudurum (%94), h?zl? duygudurum dalgalanmalar? (%89), sanr?lar (%94), i?itsel (%63) ve g?rsel hallusinasyonlar (%43) bipolar bozuklu?u olan hastalarda istatistiksel olarak anlaml? olarak daha s?k saptanm??t?r. Hareketlilik, dikkat eksikli?i ve irritabilite oranlar? bak?m?ndan her iki grup aras?nda anlaml? fark bulunmam??t?r.Sonu?: Bipolar bozuklu?u olan ?ocuk ve ergenlerde h?zl? d?ngü, irritabl duygudurum ve psikotik belirtiler s?k olarak g?rülmektedir ancak irritabilite bipolar bozukluk i?in spesifik bir semptom de?ildir.