RESUMEN
OBJECTIVE: To examine the prospective relationship between age of onset of bipolar disorder and the demographic and clinical characteristics, treatment, new onset of psychiatric comorbidity, and psychosocial functioning among adults with bipolar disorder. STUDY DESIGN: As part of the National Epidemiologic Survey on Alcohol and Related Conditions, 1600 adults who met lifetime Statistical Manual of Mental Disorders, 4th edition criteria for bipolar disorder-I (n = 1172) and bipolar disorder-II (n = 428) were included. Individuals were evaluated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV version for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and data were analyzed from Waves 1 and 2, approximately 3 years apart. Individuals with bipolar disorder were divided into three age at onset groups: childhood (<13 years old, n = 115), adolescence (13-18 years old, n = 396), and adulthood (>19 year old, n = 1017). RESULTS: After adjusting for confounding factors, adults with childhood-onset bipolar disorder were more likely to see a counselor, have been hospitalized, and have received emergency room treatment for depression compared with those with adulthood-onset bipolar disorder. By contrast, there were no differences in the severity of mania or hypomania, new onset of comorbidity, and psychosocial functioning by age of bipolar disorder onset. CONCLUSIONS: Childhood-onset bipolar disorder is prospectively associated with seeking treatment for depression, an important proxy for depressive severity. Longitudinal studies are needed in order to determine whether prompt identification, accurate diagnosis, and early intervention can serve to mitigate the burden of childhood onset on the long-term depressive burden of bipolar disorder.
Asunto(s)
Edad de Inicio , Trastorno Bipolar/complicaciones , Depresión/complicaciones , Servicios de Salud Mental/estadística & datos numéricos , Adolescente , Adulto , Trastorno Bipolar/epidemiología , Trastorno Bipolar/terapia , Niño , Comorbilidad , Depresión/epidemiología , Depresión/terapia , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Estado de Salud , Hospitalización , Humanos , Estudios Longitudinales , Masculino , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Clase Social , Estados Unidos , Adulto JovenRESUMEN
Introducción. Los neurofibromas solitarios son tumores benignos de carácter hereditario, que presentan variantes. Las manifestaciones clínicas cambian según su localización y, ocasionalmente, son similares a las de la neurofibromatosis. Usualmente, los neurofibromas están localizados en piel y raramente en otras partes. El único tratamiento es la resección quirúrgica. Su transformación maligna y recurrencia son poco usuales. Objetivo. Reportar el caso de un paciente masculino de 19 años, sin neurofibromatosis, con un neurofibroma solitario en pared abdominal. Materiales y métodos. Se incluyeron artículos encontrados en Proquest, Pubmed y Ovid. Las palabras clave utilizadas en la búsqueda fueron neurofibroma, tumores de la vaina neural y reporte de caso. La búsqueda está actualizada hasta el 24 de mayo de 2007. Conclusiones. Éste parece ser el primer reporte de un caso con estas características en la literatura médica en inglés y en español.
Introduction. Solitary neurofibromas are benign tumors, often the manifestation of neurofibromatosis, and reflect a hereditary pathology with several variants. The clinical manifestations of solitary neurofibromas change according to their location and can generate a variety of symptoms. Usually, solitary neurofibromas are located in the skin and rarely in other places. Surgical removal is the only treatment; malignant transformation and recurrence are unusual. Objective. A case is reported of solitary neurofibroma in the abdominal wall of a 19-year-old patient without neurofibromatosis. Materials and methods. Articles included are from Proquest, Pubmed and Ovid databases. Key words used were neurofibroma, tumors of the neural sheath, and case report. The search is current as of May 24, 2007. Conclusions. This case appears to be the first one with these characteristics reported in the English and Spanish medical literature.
Asunto(s)
Pared Abdominal , Neoplasias de la Vaina del Nervio , Neurofibroma , Neurofibromatosis , FibroblastosRESUMEN
INTRODUCTION: Solitary neurofibromas are benign tumors, often the manifestation of neurofibromatosis, and reflect a hereditary pathology with several variants. The clinical manifestations of solitary neurofibromas change according to their location and can generate a variety of symptoms. Usually, solitary neurofibromas are located in the skin and rarely in other places. Surgical removal is the only treatment; malignant transformation and recurrence are unusual. OBJECTIVE: A case is reported of solitary neurofibroma in the abdominal wall of a 19-year-old patient without neurofibromatosis. MATERIALS AND METHODS: Articles included are from Proquest, Pubmed and Ovid databases. Key words used were neurofibroma, tumors of the neural sheath, and case report. The search is current as of May 24, 2007. CONCLUSIONS: This case appears to be the first one with these characteristics reported in the English and Spanish medical literature.