Post Robert M
Bipolar Collaborative Network, Chevy Chase, MD, USA.
J Clin Psychiatry. 2005;66 Suppl 5:5-10.
Bipolar disorder is a chronic, intermittent illness that is associated with high morbidity and mortality. In addition, patients with bipolar disorder often have comorbid psychiatric conditions (such as anxiety disorders, alcohol or substance abuse, and eating disorders) or medical disorders (such as obesity), which result in increased burden of illness for the patients, family members, and treating clinicians. Although bipolar disorder consists of recurring episodes of mania and depression, patients spend more time depressed than manic. Bipolar depression is associated with a greater risk of suicide and of impairment in work, social, or family life than mania. This health burden also results in direct and indirect economic costs to the individual and society at large. Bipolar depression is often undiagnosed or misdiagnosed as unipolar depression, resulting in incorrect or inadequate treatment. Available treatments for bipolar depression include medications such as lithium, selected anticonvulsants, and the atypical antipsychotics. Traditional antidepressants are not recommended as monotherapy for bipolar depression as they can induce switching to mania. Early and accurate diagnosis, aggressive management, and earlier prophylactic treatment regimens are needed to overcome the impact of depressive episodes in patients with bipolar disorder.
双相情感障碍是一种慢性、间歇性疾病，与高发病率和高死亡率相关。此外，双相情感障碍患者常伴有共病精神疾病（如焦虑症、酒精或物质滥用以及饮食失调）或躯体疾病（如肥胖），这给患者、家庭成员和治疗临床医生带来了更大的疾病负担。尽管双相情感障碍由反复出现的躁狂和抑郁发作组成，但患者处于抑郁状态的时间比躁狂状态更长。与躁狂相比，双相抑郁与更高的自杀风险以及工作、社交或家庭生活受损风险相关。这种健康负担也给个人和整个社会带来了直接和间接的经济成本。双相抑郁常常未被诊断或被误诊为单相抑郁，导致治疗不正确或不充分。双相抑郁的现有治疗方法包括使用锂盐、某些抗惊厥药物和非典型抗精神病药物等。传统抗抑郁药不推荐作为双相抑郁的单一疗法，因为它们可能诱发转躁。需要早期准确诊断、积极管理和更早的预防性治疗方案，以克服双相情感障碍患者抑郁发作的影响。
