Harrow M, Goldberg J F, Grossman L S, Meltzer H Y
Department of Psychiatry, Michael Reese Hospital and Medical Center, Chicago, Ill 60616.
Arch Gen Psychiatry. 1990 Jul;47(7):665-71. doi: 10.1001/archpsyc.1990.01810190065009.
To study outcome in manic patients treated under routine clinical conditions, 73 manic and 66 unipolar depressed patients were followed up 1.7 years after hospitalization. A surprisingly large percentage of manic patients showed difficulty in post-hospital adjustment, and over 40% experienced a manic syndrome during the follow-up period. Manic patients showed poorer outcomes than did unipolar depressives. Manic patients taking lithium carbonate did not show better outcome than those not taking lithium carbonate. The results suggest (1) many hospitalized manic patients have a severe, recurrent, and pernicious disorder; and (2) in routine clinical practice, lithium carbonate treatment is an effective prophylaxis for fewer than the 70% to 80% of manic patients previously reported.
为研究在常规临床条件下接受治疗的躁狂症患者的预后情况，73名躁狂症患者和66名单相抑郁症患者在住院1.7年后接受了随访。令人惊讶的是，有很大比例的躁狂症患者在出院后出现了适应困难，超过40%的患者在随访期间经历了躁狂综合征。躁狂症患者的预后比单相抑郁症患者更差。服用碳酸锂的躁狂症患者的预后并不比未服用碳酸锂的患者更好。结果表明：（1）许多住院的躁狂症患者患有严重、复发性且有害的疾病；（2）在常规临床实践中，碳酸锂治疗对躁狂症患者的有效预防率低于之前报道的70%至80%。
