Gaudiano Brandon A, Uebelacker Lisa A, Miller Ivan W
Brown Medical School and Butler Hospital, Providence, Rhode Island 02906, USA.
J Nerv Ment Dis. 2007 Mar;195(3):226-32. doi: 10.1097/01.nmd.0000243763.81487.4d.
Previous research is inconsistent regarding the significance of mood-incongruent psychotic symptoms in relation to the severity and course of bipolar disorder. In the present study, bipolar I patients were assessed at index hospitalization using standardized symptom measures and followed up to 28 months. We contrasted the symptomatic course in patients experiencing mood-congruent versus mood-incongruent psychotic symptoms. Results revealed that patients spent an average of 29% of the time during follow-up in a mood episode, but only 5% of the time with psychotic symptoms. Few differences were found at the index hospitalization and no differences were found on any longitudinal course variables between mood-congruence subtypes. Although experiencing high levels of psychosis at baseline, both subtypes improved considerably following hospitalization, and psychotic symptom levels remained relatively stable. Current results suggest that when provided efficacious treatment, mood-incongruent psychotic mania does not predict a worse symptomatic course of illness.
先前的研究在心境不和谐的精神病性症状与双相情感障碍的严重程度及病程的相关性方面存在不一致的观点。在本研究中，对双相I型障碍患者在首次住院时使用标准化症状量表进行评估，并随访28个月。我们对比了出现心境和谐与心境不和谐的精神病性症状患者的症状病程。结果显示，患者在随访期间平均有29%的时间处于心境发作状态，但仅有5%的时间伴有精神病性症状。在首次住院时未发现明显差异，且在心境和谐亚型之间的任何纵向病程变量上均未发现差异。尽管在基线时精神病性症状水平较高，但两种亚型在住院后均有显著改善，且精神病性症状水平保持相对稳定。目前的结果表明，当给予有效治疗时，心境不和谐的精神病性躁狂并不预示着更差的疾病症状病程。
