气质在双相抑郁与单相重度抑郁患者临床鉴别中的作用
Temperament in the clinical differentiation of depressed bipolar and unipolar major depressive patients.
作者信息
Mendlowicz Mauro V, Akiskal Hagop S, Kelsoe John R, Rapaport Mark H, Jean-Louis Girardin, Gillin J Christian
机构信息
Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil.
出版信息
J Affect Disord. 2005 Feb;84(2-3):219-23. doi: 10.1016/j.jad.2004.01.013.
OBJECTIVE
To examine differences in temperament profiles between patients with recurrent unipolar and bipolar depression.
METHOD
Depressed individuals with recurrent major depressive disorder (MDD) (n = 94) and those with bipolar (n = 59) disorders (about equally divided between types I and II) were recruited by newspaper advertisement, radio and television announcements, flyers and newsletters, and word of mouth. All patients were interviewed using the Structured Clinical Interview for DSM III-R (SCID) and had the severity of their depressive episode assessed by means of the 17-item Hamilton Rating Scale for Depression. All patients filled out the TEMPS-A, a validated instrument.
RESULTS
Temperament differences between bipolar and MDD patients were examined using MANCOVA. Overall significant effect of the fixed factor (bipolar vs. unipolar) was noted for the temperament scores [Hotelling's F((5,142)) = 2.47, p < 0.05]. Overall effects were found for age [F((5,142)) = 2.40, p < 0.05], but not for gender and severity of depression [F((5,142)) = 1.65, p = 0.15 and F((5,142)) = 0.66, p = 0.66, respectively]. Dependent variables included the five subscales of the TEMPS-A, but only the cyclothymic temperament scores showed significant between-group differences.
LIMITATION
Small bipolar subsample cell sizes did not permit to test the specificity of the findings for bipolar II vs. bipolar I patients.
CONCLUSION
The finding that the clyclothymic subscale is significantly elevated in the bipolar vs. the unipolar depressive group supports the theoretical assumptions upon which the scale is based, and suggests that it might become a useful tool for clinical and research purposes.
目的
研究复发性单相抑郁和双相抑郁患者的气质特征差异。
方法
通过报纸广告、广播电视公告、传单和时事通讯以及口碑招募患有复发性重度抑郁症(MDD)的抑郁个体(n = 94)和患有双相情感障碍的个体(n = 59)(I型和II型大致平分)。所有患者均使用DSM III-R结构化临床访谈(SCID)进行访谈,并通过17项汉密尔顿抑郁评定量表评估其抑郁发作的严重程度。所有患者均填写了经过验证的TEMPS-A量表。
结果
使用多变量协方差分析(MANCOVA)检查双相情感障碍患者和MDD患者之间的气质差异。气质得分的固定因素(双相情感障碍与单相情感障碍)总体上有显著影响[霍特林T方检验F((5,142)) = 2.47,p < 0.05]。发现年龄有总体影响[F((5,142)) = 2.40,p < 0.05],但性别和抑郁严重程度没有总体影响[分别为F((5,142)) = 1.65,p = 0.15和F((5,142)) = 0.66,p = 0.66]。因变量包括TEMPS-A量表的五个子量表,但只有环性气质得分显示出显著的组间差异。
局限性
双相情感障碍子样本量小,无法检验双相II型与双相I型患者研究结果的特异性。
结论
双相抑郁组与单相抑郁组相比,环性气质子量表显著升高,这一发现支持了该量表所基于的理论假设,并表明它可能成为临床和研究目的的有用工具。