사춘기 이전 발병 양극성 장애의 임상적 특성

Clinical Characteristics of Bipolar Disorder Patients with Prepubertal Onset - A Pilot Study

Objectives This case-based, small scale study was undertaken to identify the characteristics clinical features of children who exhbiit rare prepubertal onset bipolar disorder. Methods We analyzed the clinical records of 13 children who had been hospitalized and diagnosed with bipolar disorder. Clinical characteristics and cognitive function of these patients was based on psychiatrists’ medical records and psychologists’ evaluation reports. Results Eleven (84.6%) subjects exhibited clinical features of mixed mania and had a chronic clinical course. They never fulfilled the full criteria of the Diagnostic Statistical Manual of Mental disorders- Fourth Edition (DSM-IV) for manic or hypomanic episodes. Mean age at onset of typical symptoms of bipolar disorder was 9.38 (SD=1.80) and mean age at admission was 12.00 (SD=2.45). Twelve (92.3%) had psychiatric comorbidity. Attention-deficit/hyperactivity disorder was the most prevalent comorbid disease and mean age of onset of it was 6.23 (SD=2.17). Conclusion Subjects with prepubertal onset bipolar disorder showed atypical clinical features. These results suggest that most prepubertal onset bipolar disorder patients fail to meet the DSM-IV criteria for typical bipolarⅠdisorder and therefore, we need to develop alternative diagnostic criteria for pediatric bipolar disorder