双相情感障碍中比单相情感障碍更常见的抑郁症类型：波兰DEP-BI研究结果

Types of depression more frequent in bipolar than in unipolar affective illness: results of the Polish DEP-BI study.

作者信息

Rybakowski Janusz K, Suwalska Aleksandra, Lojko Dorota, Rymaszewska Joanna, Kiejna Andrzej

机构信息

Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Psychopathology. 2007;40(3):153-8. doi: 10.1159/000100004. Epub 2007 Feb 22.

DOI:10.1159/000100004

PMID:17318007

Abstract

BACKGROUND

The aim of the study was to assess the relative frequency of various kinds of depression in patients with bipolar and unipolar affective illness. The study was performed in the framework of the DEP-BI project aimed at assessing the prevalence of bipolar disorders among depressive outpatients treated by psychiatrists in Poland.

METHODS

Eight-hundred and eighty patients (237 male, 643 female) participated in the study. The patients were classified into the following diagnostic categories: bipolar affective illness type I, type II, bipolar spectrum disorder and unipolar affective illness. The various kinds of depression in each group were assessed by means of a semistructured questionnaire added to the diagnostic interview.

RESULTS

In the group of bipolar patients, a significantly higher frequency of psychotic depression in male compared to female patients was observed. Male bipolar patients compared with unipolar depressed ones had significantly more episodes of psychotic depression (odds ratio, OR, 4.29) and atypical depression (hypersomnia and hyperphagia; OR 2.82), and those with bipolar spectrum had more episodes of treatment-resistant depression (OR 2.56). Female bipolar patients compared with unipolar depressed ones had significantly more frequently an early onset of depression (before 25 years; OR 2.95) and postpartum depression (OR 2.48). On the other hand, the percentage of agitation, irritability, distractibility, thought racing and panic attacks during depression was not different in patients with bipolar and unipolar affective illness either in males or females.

CONCLUSIONS

Some kinds of depression occur with a higher frequency in patients with bipolar compared to unipolar affective illness. The occurrence of a given type of depression may constitute an aid for the diagnosis of bipolar illness. The results of this study did not confirm the concept of bipolar mixed depression based on the presence of anxiety symptoms occurring during the depressive episode. The limitation of our study may be the lack of formal criteria or a structured interview to assess the symptoms occurring during depressive episodes.

摘要

背景

本研究旨在评估双相情感障碍和单相情感障碍患者中各类抑郁症的相对频率。该研究是在DEP-BI项目框架内进行的，旨在评估波兰精神科医生治疗的抑郁症门诊患者中双相情感障碍的患病率。

方法

880名患者（237名男性，643名女性）参与了本研究。患者被分为以下诊断类别：I型双相情感障碍、II型双相情感障碍、双相谱系障碍和单相情感障碍。通过在诊断访谈中添加的半结构化问卷评估每组中的各类抑郁症。

结果

在双相情感障碍患者组中，观察到男性精神病性抑郁症的频率显著高于女性患者。与单相抑郁症患者相比，男性双相情感障碍患者有更多的精神病性抑郁症发作（优势比，OR，4.29）和非典型抑郁症（嗜睡和暴饮暴食；OR 2.82），双相谱系障碍患者有更多难治性抑郁症发作（OR 2.56）。与单相抑郁症患者相比，女性双相情感障碍患者抑郁症的发病年龄显著更早（25岁之前；OR 2.95），产后抑郁症的发生率也更高（OR 2.48）。另一方面，双相情感障碍和单相情感障碍患者在抑郁期间出现的激动、易怒、注意力分散、思维奔逸和惊恐发作的比例在男性和女性中没有差异。