Marsh Wendy K, Templeton Amanda, Ketter Terence A, Rasgon Natalie L
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, United States.
J Psychiatr Res. 2008 Feb;42(3):247-51. doi: 10.1016/j.jpsychires.2006.12.006. Epub 2007 Jan 30.
Data are emerging in bipolar disorder regarding mood across phases of the female reproductive life, yet information about mood during the menopausal transition remains limited. The menopausal transition in women without mood disorders is associated with an increase in depression. This study assesses mood course during the menopausal transition in women with bipolar disorder.
We monitored mood episodes in 47 women with bipolar disorder ages 45-55 for 17.0+/-14.0 months with systematic treatment enhancement program for bipolar disorder (STEP-BD) standardized evaluations. Charts were additionally reviewed for menstrual status and menstrual history, as well as mood episode type, duration, frequency and history.
During the menopausal transition 68% of women with bipolar disorder experienced at least one depressive episode. Depression (but not mood elevation) episode frequency significantly increased during the menopausal transition compared to reported frequency during patients' reproductive years. History of pre-menstrual and or post-partum mood instability did not predict perimenopausal mood episodes.
Women with bipolar disorder experience a high frequency of depressive episodes during perimenopausal years and this frequency appears greater than during prior reproductive years. Prospective controlled studies are needed to better understand the course of mood episodes and to enhance the effectiveness of managing bipolar disorder during the menopausal transition.
关于双相情感障碍患者在女性生殖生活各阶段的情绪数据不断涌现,但关于绝经过渡期间情绪的信息仍然有限。没有情绪障碍的女性在绝经过渡期间与抑郁症的增加有关。本研究评估双相情感障碍女性在绝经过渡期间的情绪变化过程。
我们使用双相情感障碍系统治疗强化项目(STEP-BD)标准化评估,对47名年龄在45 - 55岁的双相情感障碍女性的情绪发作进行了17.0±14.0个月的监测。此外,还查阅了病历以了解月经状况和月经史,以及情绪发作类型、持续时间、频率和病史。
在绝经过渡期间,68%的双相情感障碍女性经历了至少一次抑郁发作。与患者生殖年限期间报告的频率相比,绝经过渡期间抑郁(而非情绪高涨)发作频率显著增加。经前和/或产后情绪不稳定史并不能预测围绝经期情绪发作。
双相情感障碍女性在围绝经期经历抑郁发作的频率较高,且这一频率似乎高于之前的生殖年限。需要进行前瞻性对照研究,以更好地了解情绪发作的过程,并提高在绝经过渡期间管理双相情感障碍的有效性。