Henry Chantal, Van den Bulke Donatienne, Bellivier Frank, Roy Isabelle, Swendsen Joël, M'Baïlara Katia, Siever Larry J, Leboyer Marion
Département de Psychiatrie adulte, Bâtiment Lescure, CHS Charles Perrens, 121 rue de la Béchade, 33076 Bordeaux Cedex, France.
Psychiatry Res. 2008 May 30;159(1-2):1-6. doi: 10.1016/j.psychres.2005.11.016. Epub 2008 Mar 4.
Bipolar disorders are usually defined by alternative mood states, but a more precise characterization of the euthymic period could provide further insights into the pathophysiology of bipolar disorders. Surprisingly, few studies have investigated core affective dimensions in euthymic bipolar patients. In this study, we assessed 179 euthymic bipolar patients (score<12 on the Montgomery-Asberg Depression Scale and a score<6 on the Bech-Rafaelsen Mania Scale) compared with 86 control subjects using French versions of the Affective Lability Scale (ALS) and the Affect Intensity Measure (AIM). Data were analyzed by logistic regression. Our results showed that euthymic bipolar subjects reported having more intense emotions than controls and also had a higher affective lability. High scores in both affective dimensions were associated with a significantly higher risk for psychiatric axis I comorbidity. Moreover, a high affective lability score was associated with an earlier age of onset for bipolar disease. Affective lability and affect intensity might be two core dimensions of bipolar disorder during euthymic periods, suggesting that bipolar disorder is not circumscribed to mood episodes but also affects emotional reactivity between episodes. Both dimensions could account for the stress reactivity of bipolar patients that may lead to relapses.
双相情感障碍通常由交替出现的情绪状态来定义,但对心境正常期进行更精确的特征描述可以为双相情感障碍的病理生理学提供进一步的见解。令人惊讶的是,很少有研究调查心境正常的双相情感障碍患者的核心情感维度。在本研究中,我们使用法语版的情感易激惹量表(ALS)和情感强度量表(AIM),对179名心境正常的双相情感障碍患者(蒙哥马利-阿斯伯格抑郁量表得分<12分,贝克-拉法尔森躁狂量表得分<6分)与86名对照者进行了评估。数据通过逻辑回归进行分析。我们的结果表明,心境正常的双相情感障碍患者报告的情绪比对照组更强烈,情感易激惹性也更高。这两个情感维度的高分与精神科I轴共病的显著更高风险相关。此外,高情感易激惹性得分与双相情感障碍的发病年龄较早有关。情感易激惹性和情感强度可能是双相情感障碍心境正常期的两个核心维度,这表明双相情感障碍不仅局限于情绪发作,还会影响发作间期的情绪反应性。这两个维度都可以解释双相情感障碍患者可能导致复发的应激反应性。