今日文獻聚焦青少年雙相情緒障礙的風險因子與共病機制,特別是在睡眠-晝夜節律調節、物質使用共病遺傳基礎、早期精神病發展軌跡(如理論心智與孤獨感)方面有新突見;臨床轉化潛力最高者為針對睡眠問題的干預試驗。
BMJ open · MELODY trial: study protocol for a 12-week randomised controlled trial of adjunctive melatonin, digital cognitive behavioural therapy for insomnia or pill placebo to improve depressive symptoms in young adults with mood disorders.
該試驗將評估褪黑素或數位 CBT-I 作為輔助治療於情緒障礙(含雙相 II 型)青年 depressive symptom 改善效果,具高實用性與創新性。
Biological psychiatry · Genetic liability to addiction underlies comorbid bipolar and substance use disorders.
透過基因統計模型證明物質使用障礙(而非一般物質使用)與雙相情緒障礙有顯著共享遺傳基礎,尤其涉及多巴胺轉導與內顆粒神經元功能。
Schizophrenia bulletin · Prolonged Childhood and Adolescent Loneliness in First-Episode Psychosis: Synergistic Polygenic Effects and Functional Outcomes.
回顧性評估顯示,12-16 歲期間的孤獨感顯著增加首次精神病發作(FEP)風險(OR=2.34),並與精神分裂多基因風險互動預後較差,女性尤其關聯情感性精神病。
Schizophrenia bulletin · Suicidal Ideation and Non-suicidal Self-injury Following Childhood Psychotic Experiences in Adolescents at Familial High Risk of Schizophrenia or Bipolar Disorder-The Danish High Risk and Resilience Study, VIA 15.
中童年期(7-11 歲)精神病經驗顯著預測青少年自殺念頭(OR=3.8)與自傷行為(OR=2.8),當經驗持續存在時風險更高(SI OR=5.5),不論家族風險群。
Schizophrenia bulletin · Theory of Mind and the Association with Psychotic Experiences in 11-Year-Old Children at Familial High-Risk of Schizophrenia or Bipolar Disorder and Population-Based Controls: The Danish High Risk and Resilience Study, VIA 11.
雙相家族高風險兒童顯著較差的明顯理論心智效應(d=0.42 vs 對照),而隱性過度心理化(非明顯 ToM)與知覺性精神病經驗正相關,提示不同 ToM 成份在精神病發展中的分離角色。