Benazzi Franco
Hecker Psychiatry Research Center, University of California at San Diego (USA) Collaborating Center, Forli, Italy.
Curr Opin Psychiatry. 2006 Jan;19(1):1-8. doi: 10.1097/01.yco.0000194145.03895.bc.
The aim of this review is to highlight recent studies that have questioned the current split of mood disorders into the categories of bipolar and depressive disorders.
A continuity between bipolar disorders (mainly bipolar II disorder) and major depressive disorder was supported by several lines of evidence: depressive mixed states (mixed depression) and dysphoric (mixed) hypomania (opposite polarity symptoms in the same episode do not support the splitting between mania/hypomania and depression); family history, major depressive disorder is the most common mood disorder in relatives of bipolar probands; lack of points of rarity between the depressive syndromes of bipolar II disorder and major depressive disorder; bipolar features in major depressive disorder; major depressive disorder shifting to bipolar disorders; history of manic/hypomanic symptoms in major depressive disorder and correlation between lifetime manic/hypomanic symptoms and depressive symptoms in major depressive disorder; factors of hypomania inside major depressive disorder; recurrent course of major depressive disorder; depression more common than mania and hypomania in bipolar disorders; trait mood lability in major depressive disorder.
This review of the recent findings on the relationship between bipolar disorders (especially bipolar II disorder) and depressive disorders seems to support a continuity among mood disorders, and runs against the current classification of mood disorders dividing them into independent categories. Further research is needed in the area, in part because of its possible treatment impact.
本综述旨在强调近期一些对当前将心境障碍分为双相障碍和抑郁障碍这一分类提出质疑的研究。
双相障碍(主要是双相II型障碍)与重度抑郁症之间存在连续性,有几条证据支持这一点:抑郁混合状态(混合性抑郁)和烦躁(混合性)轻躁狂(同一发作中相反极性症状不支持将躁狂/轻躁狂与抑郁分开);家族史方面,重度抑郁症是双相障碍先证者亲属中最常见的心境障碍;双相II型障碍的抑郁综合征与重度抑郁症之间缺乏罕见特征点;重度抑郁症中的双相特征;重度抑郁症转变为双相障碍;重度抑郁症中有躁狂/轻躁狂症状史以及重度抑郁症中终生躁狂/轻躁狂症状与抑郁症状之间的相关性;重度抑郁症中的轻躁狂因素;重度抑郁症的复发病程;双相障碍中抑郁比躁狂和轻躁狂更常见;重度抑郁症中的特质情绪不稳定。
对双相障碍(尤其是双相II型障碍)与抑郁障碍之间关系的近期研究发现综述似乎支持心境障碍之间存在连续性,这与当前将心境障碍分为独立类别的分类方式相悖。该领域需要进一步研究,部分原因在于其可能对治疗产生影响。