3014 名撒丁岛双相和重度抑郁障碍患者的发病年龄。
Age at onset in 3014 Sardinian bipolar and major depressive disorder patients.
机构信息
Department of Psychiatry, Harvard Medical School and International Consortium for Psychotic and Mood Disorders Research, McLean Division of Massachusetts General Hospital, Boston, MA, USA.
出版信息
Acta Psychiatr Scand. 2010 Jun;121(6):446-52. doi: 10.1111/j.1600-0447.2009.01523.x. Epub 2009 Dec 23.
OBJECTIVE
To test if onset age in major affective illnesses is younger in bipolar disorder (BPD) than unipolar-major depressive disorder (UP-MDD), and is a useful measure.
METHOD
We evaluated onset-age for DSM-IV-TR major illnesses in 3014 adults (18.5% BP-I, 12.5% BP-II, 69.0% UP-MDD; 64% women) at a mood-disorders center.
RESULTS
Median and interquartile range (IQR) onset-age ranked: BP-I = 24 (19-32) < BP-II = 29 (20-40) < UP-MDD = 32 (23-47) years (P < 0.0001), and has remained stable since the 1970s. In BP-I patients, onset was latest for hypomania, and depression presented earlier than in BP-II or UP-MDD cases. Factors associated with younger onset included: i) being unmarried, ii) more education, iii) BPD-diagnosis, iv) family-history, v) being employed, vi) ever-suicidal, vii) substance-abuse and viii) ever-hospitalized. Onset-age distinguished BP-I from UP-MDD depressive onsets with weak sensitivity and specificity.
CONCLUSION
Onset age was younger among BPD than MDD patients, and very early onset may distinguish BPD vs. UP-MDD with depressive-onset.
目的
测试双相障碍（BPD）的发病年龄是否比单相重性抑郁障碍（UP-MDD）年轻，以及是否是一个有用的衡量标准。
方法
我们评估了 3014 名成年患者（18.5%为 BPI，12.5%为 BPII，69.0%为 UP-MDD；64%为女性）在心境障碍中心的 DSM-IV-TR 主要疾病的发病年龄。
结果
中位数和四分位距（IQR）发病年龄的排序为：BPI=24（19-32）<BPII=29（20-40）<UP-MDD=32（23-47）岁（P<0.0001），且自 20 世纪 70 年代以来一直保持稳定。在 BPI 患者中，轻躁狂的发病最晚，而与 BPII 或 UP-MDD 病例相比，抑郁的发病更早。与发病年龄较轻相关的因素包括：i）未婚，ii）受教育程度较高，iii）BPD 诊断，iv）家族史，v）就业，vi）曾有自杀意念，vii）物质滥用和 viii）曾住院治疗。发病年龄可区分 BPI 与 UP-MDD 的抑郁发作，但敏感性和特异性均较弱。
结论
BPD 患者的发病年龄比 MDD 患者年轻，且发病年龄极早可能有助于区分 BPD 与 UP-MDD 的抑郁发作。
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