MacQueen Glenda M, Marriott Michael, Begin Helen, Robb Janine, Joffe Russell T, Young L Trevor
Mood Disorders Program, McMaster University, Hamilton, ON, Canada.
Bipolar Disord. 2003 Oct;5(5):349-55. doi: 10.1034/j.1399-5618.2003.00048.x.
Many patients with bipolar disorder (BD) do not regain full function following an acute illness episode, but the extent to which this impairment is the result of persistent symptoms has not been well established. This study examined factors associated with persistent subsyndromal symptoms in a well characterized group of BD patients who were prospectively followed for an average of 3 years.
Detailed life charting data from 138 patients with BD were reviewed. Patients were categorized into euthymic, subsyndromal or syndromal groups according to the clinical state during their most recent year of follow-up. The three groups were then examined with respect to comorbidity, function and treatment received.
Patients with subsyndromal symptoms had high rates of comorbid anxiety disorders, and were more likely to have increased rates of eating disorders as well. Patients with subsyndromal symptoms had lower global assessment of function (GAF) scores than euthymic patients, and had as many clinic contacts and medication trials as patients with full episodes of illness.
Persistent subsyndromal symptoms in BD patients are associated with high rates of comorbidity that is important to recognize and treat in order to optimize mood and functioning.
许多双相情感障碍（BD）患者在急性发病期后并未恢复全部功能，但这种功能损害在多大程度上是由持续症状导致的，目前尚未明确。本研究在一组特征明确的BD患者中进行前瞻性随访，平均随访3年，以探究与持续性亚综合征症状相关的因素。
回顾了138例BD患者的详细生活记录数据。根据患者在最近一年随访期间的临床状态，将其分为心境正常组、亚综合征组或综合征组。然后对这三组患者的共病情况、功能状况和接受的治疗进行了检查。
有亚综合征症状的患者共病焦虑症的发生率较高，饮食失调的发生率也可能更高。有亚综合征症状的患者的功能总体评估（GAF）得分低于心境正常的患者，且门诊就诊次数和药物试验次数与有完全发作性疾病的患者一样多。
BD患者的持续性亚综合征症状与高共病率相关，认识和治疗这些共病对于优化情绪和功能很重要。
