波兰因重度抑郁症接受治疗的精神科门诊患者中的双相情感障碍

Bipolar mood disorders among Polish psychiatric outpatients treated for major depression.

作者信息

Rybakowski Janusz K, Suwalska Aleksandra, Lojko Dorota, Rymaszewska Joanna, Kiejna Andrzej

机构信息

Department of Adult Psychiatry, Poznan University of Medical Sciences, ul. Szpitalna 27/33, 60-572 Poznan, Poland.

出版信息

J Affect Disord. 2005 Feb;84(2-3):141-7. doi: 10.1016/j.jad.2004.01.005.

Abstract

BACKGROUND

Significant proportion of patients treated for depression may have various types of bipolar mood disorders. The aim of the study was to assess the frequency of bipolar disorders among outpatients having at least one major depressive episode, treated by 96 psychiatrists, representing all regions of Poland.

METHODS

The study included 880 patients (237 male, 643 female), identified to following diagnostic categories: bipolar I, bipolar II, bipolar spectrum disorder and major depressive disorder.

RESULTS

Bipolar mood disorders were found in 61.2% of patients studied, bipolar I more frequent in men and bipolar II in women, and bipolar spectrum in 12% of patients. Patients with age ranges 19-49 and 50-65 years did not differ as to the percentage of diagnostic categories. Patients with bipolar mood disorders compared to major depressive disorder had significantly more frequent family history of bipolar disorder, premorbid hyper- or cyclothymic personality, early onset of depression, symptoms of hypersomnia and hyperphagia, psychotic depression, post-partum depression, and treatment-resistant depression. Bipolar spectrum patients had most clinical features similar to classic types of bipolar disorders.

LIMITATIONS

Neither structured interview for family history, nor formal criteria for a number of clinical manifestations were used. The population treated by psychiatrists may not be representative and present a subgroup with more severe mood disorders.

CONCLUSIONS

Bipolar mood disorders may be very prevalent among depressive outpatients treated by psychiatrists in Poland, which is confirmed by the results of recent studies. Bipolar patients (including bipolar spectrum) significantly differ from major depressive disorder as to numerous clinical features related mostly to depressive episode.

摘要

背景

接受抑郁症治疗的患者中有相当比例可能患有各种类型的双相情感障碍。本研究的目的是评估在波兰所有地区的96名精神科医生治疗的至少有一次重度抑郁发作的门诊患者中双相情感障碍的发生率。

方法

该研究纳入了880名患者(男性237名,女性643名),确定其属于以下诊断类别:双相I型、双相II型、双相谱系障碍和重度抑郁症。

结果

在所研究的患者中,61.2%发现患有双相情感障碍,双相I型在男性中更常见,双相II型在女性中更常见,12%的患者为双相谱系障碍。年龄在19 - 49岁和50 - 65岁的患者在诊断类别百分比方面没有差异。与重度抑郁症患者相比,双相情感障碍患者有双相情感障碍家族史、病前环性或轻躁狂人格、抑郁早发、嗜睡和多食症状、精神病性抑郁、产后抑郁以及难治性抑郁的比例显著更高。双相谱系障碍患者的大多数临床特征与经典双相情感障碍类型相似。

局限性

既未使用结构化家族史访谈,也未使用一些临床表现的正式标准。精神科医生治疗的人群可能不具有代表性,且呈现出一个患有更严重情绪障碍的亚组。

结论

波兰精神科医生治疗的抑郁门诊患者中双相情感障碍可能非常普遍,近期研究结果证实了这一点。双相情感障碍患者(包括双相谱系障碍患者)在与抑郁发作相关的众多临床特征方面与重度抑郁症患者有显著差异。

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