Bogdanowicz E
II Kliniki Psychiatrycznej Instytutu Psychiatrii i Neurologii.
Psychiatr Pol. 1991 May-Aug;25(3-4):70-5.
The study aimed to establish prognostic considerations for the course of bipolar affective disorder from its onset till first manic phase in persons in whom depression was that first clinical phase of the disorder. Studied group comprised of 80 patients (34 males and 46 females) with the disorder lasting for 11 to 50 years. Within the evaluated period as positive prognostic factors were identified an early onset of the disorder (before 30 years of age), a short (lasting less than 3 months) first depressed phase and a long (above 5 years) first remission. In women and in persons who had lost their parents before 14 years of age the course of disorder was more severe as indicated by duration and frequency of depressed phases. The time of duration of the disorder until the first manic phase was not influenced by pharmacotherapy. Both, treated and untreated depressions more frequently ended with remission (77% of episodes) than switch to mania (23% of episodes). Perris' criterion for diagnosis of unipolar affective disorder has rather limited value since in almost half of the studied individuals a risk of occurrence of a manic phase following three successive depressed phases still existed and diagnosis was still an open question.
该研究旨在为双相情感障碍从发病直至首次躁狂发作阶段建立预后考量，这些患者的首发临床阶段为抑郁。研究组包括80名患者（34名男性和46名女性），病程为11至50年。在评估期内，确定为阳性预后因素的有：疾病早发（30岁之前）、首次抑郁期短（持续时间少于3个月）以及首次缓解期长（超过5年）。在女性以及14岁之前失去双亲的人群中，抑郁期的持续时间和发作频率表明疾病进程更为严重。从发病到首次躁狂发作阶段的疾病持续时间不受药物治疗影响。接受治疗和未接受治疗的抑郁发作更常以缓解告终（77%的发作），而非转变为躁狂（23%的发作）。佩里斯诊断单相情感障碍的标准价值相当有限，因为在几乎一半的研究对象中，连续三次抑郁发作后仍存在躁狂发作的风险，诊断仍存在疑问。
