Mitchell P, Parker G, Jamieson K, Wilhelm K, Hickie I, Brodaty H, Boyce P, Hadzi-Pavlovic D, Roy K
School of Psychiatry, University of New South Wales, Sydney, Australia.
J Affect Disord. 1992 Jun;25(2):97-105. doi: 10.1016/0165-0327(92)90072-e.
Although it is now more than 30 years since Leohard originally proposed the distinction between bipolar and monopolar (unipolar) forms of affective disorder, there have been relatively few studies which have investigated clinical features which may differentiate the depressed phase of bipolar disorder from unipolar depression. In this study we examined the value of a new scale for rating depressive mental state signs (the 'core' score system), and a large series of symptoms and risk factors, in distinguishing between 27 age and sex-matched pairs of bipolar and unipolar patients diagnosed as melancholic on several diagnostic criteria. In general, we found a marked similarity between the groups on clinical features of the depressive episode when allowance was made for multiple tests. Bipolar patients, however, had shorter episodes of depression and were less likely to demonstrate 'slowed movements' than unipolar subjects. There were also consistent trends on other items for psychomotor retardation to be less common and agitation to be more likely in the bipolar patients. At the least, these findings suggest that the widely-held belief that bipolar depressed patients typically have psychomotor retardation is not as clear-cut as has been previously described.
尽管自莱奥哈德最初提出双相情感障碍和单相（单极）情感障碍的区别至今已有30多年，但相对较少有研究调查过可能区分双相情感障碍抑郁期和单相抑郁症的临床特征。在本研究中，我们检验了一种用于评定抑郁精神状态体征的新量表（“核心”评分系统）以及一系列症状和危险因素在区分27对年龄和性别匹配、根据多种诊断标准被诊断为忧郁症的双相情感障碍患者和单相抑郁症患者方面的价值。总体而言，当考虑到多次检验时，我们发现两组在抑郁发作的临床特征上有显著相似性。然而，双相情感障碍患者的抑郁发作持续时间较短，与单相抑郁症患者相比，表现出“动作迟缓”的可能性较小。在其他项目上也有一致的趋势，即双相情感障碍患者中精神运动迟缓不太常见，而激越更有可能出现。至少，这些发现表明，人们普遍认为双相情感障碍抑郁患者通常有精神运动迟缓，这并不像之前所描述的那样明确。
