Benazzi Franco
Hecker Psychiatry Research Center, Forli, Italy.
Dialogues Clin Neurosci. 2006;8(2):151-61. doi: 10.31887/DCNS.2006.8.2/fbenazzi.
The current subtyping of depression is based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision (DSM-IV-TR) categorical division of bipolar and depressive disorders. Current evidence, however, supports a dimensional approach to depression, as a continuum/spectrum of overlapping disorders, ranging from bipolar I depression to major depressive disorder. Types of depression which have recently been the focus of most research will be reviewed: bipolar II depression, mixed depression, agitated depression, atypical depression, melancholic depression, recurrent brief depression, minor depressive disorder, seasonal depression, and dysthymic disorder. Most research has focused on bipolar II depression, mixed depression (defined by depression and superimposed manic/hypomanic symptoms), and atypical depression. Mixed depression, by its combination of opposite polarity symptoms, has been found to be common by systematic probing for co-occurring manic/hypomanic symptoms. Mixed depression is a treatment challenge for clinicians, because antidepressants alone (ie, not protected by mood-stabilizing agents) may worsen its manic/hypomanic symptoms, such as irritability and psychomotor agitation, which the Food and Drug Administration (FDA) has listed as possible precursors to suicidality.
目前抑郁症的亚型分类基于《精神疾病诊断与统计手册》第4版修订本（DSM-IV-TR）中对双相情感障碍和抑郁症的分类划分。然而，目前的证据支持采用维度方法来研究抑郁症，即将其视为一系列重叠疾病的连续体/谱系，范围从双相I型抑郁症到重度抑郁症。本文将对近期大多数研究关注的抑郁症类型进行综述：双相II型抑郁症、混合性抑郁症、激越性抑郁症、非典型抑郁症、 melancholic抑郁症、复发性短暂抑郁症、轻度抑郁症、季节性抑郁症和恶劣心境障碍。大多数研究集中在双相II型抑郁症、混合性抑郁症（由抑郁症叠加躁狂/轻躁狂症状定义）和非典型抑郁症上。通过系统探究共病的躁狂/轻躁狂症状发现，混合性抑郁症因其具有相反极性症状的组合而较为常见。混合性抑郁症对临床医生来说是一个治疗挑战，因为单独使用抗抑郁药（即未受心境稳定剂保护）可能会加重其躁狂/轻躁狂症状，如易怒和精神运动性激越，而美国食品药品监督管理局（FDA）已将这些症状列为可能的自杀倾向先兆。
