Miller Ivan W, Uebelacker Lisa A, Keitner Gabor I, Ryan Christine E, Solomon David A
Department of Psychiatry and Human Behavior, Brown University School of Medicine, Butler Hospital, Providence, RI, USA.
Compr Psychiatry. 2004 Nov-Dec;45(6):431-40. doi: 10.1016/j.comppsych.2004.07.005.
The course of bipolar I disorder is characterized by frequently fluctuating levels of manic and depressive symptoms. In the current study, we sought to characterize the month-by- month course of this disorder in 61 patients who were originally enrolled in a clinical trial and were followed for a mean of 23.7 months (SD = 6.1). All patients in the trial received medication management; some received family psychosocial interventions as well. On a monthly basis, we assessed symptom severity using the Modified Hamilton Rating Scale for Depression (MHRSD) and the Bech-Rafaelson Mania Scale (BRMS). Each month, we categorized each participant as fully symptomatic, partially symptomatic, or asymptomatic in terms of both depressed and manic symptoms. We found that the median percent time fully symptomatic was 8%, the median percent time partially symptomatic was 22%, and the median percent time asymptomatic was 59%. Using DSM-IV-TR criteria for defining an acute mood episode, we found that the median length of episode was 1 month, and participants experienced, on average, one episode every 8 months. Estimates concerning percent time fully symptomatic and asymptomatic converge with those reported in other datasets.
双相I型障碍的病程特点是躁狂和抑郁症状水平频繁波动。在本研究中，我们试图描述61名最初参与一项临床试验且平均随访23.7个月（标准差 = 6.1）的患者中该障碍的逐月病程。试验中的所有患者均接受药物治疗管理；部分患者还接受了家庭心理社会干预。我们每月使用改良汉密尔顿抑郁量表（MHRSD）和贝奇 - 拉法尔森躁狂量表（BRMS）评估症状严重程度。每月，我们根据抑郁和躁狂症状将每位参与者分类为完全有症状、部分有症状或无症状。我们发现，完全有症状的时间中位数百分比为8%，部分有症状的时间中位数百分比为22%，无症状的时间中位数百分比为59%。使用《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）标准来定义急性情绪发作，我们发现发作的中位数时长为1个月，参与者平均每8个月经历一次发作。关于完全有症状和无症状时间百分比的估计与其他数据集中报告的结果一致。
