双相抑郁：接受抗抑郁药治疗的临床相关性。

Bipolar depression: clinical correlates of receiving antidepressants.

机构信息

Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain.

出版信息

J Affect Disord. 2012 Jun;139(1):89-93. doi: 10.1016/j.jad.2012.01.027. Epub 2012 Mar 9.

DOI:10.1016/j.jad.2012.01.027

PMID:22406337

Abstract

BACKGROUND

The efficacy and tolerability of antidepressants (ADs) to treat or avoid episodes of depression in bipolar disorder (BPD) patients as well as reasons for using them remain unresolved.

METHODS

We analyzed patient-characteristics and outcomes of episodes of acute major depression among 290 adult, DSM-IV BPD patients (71% type-I, 52% women) at the Hospital Clinic of Barcelona; 80% were given an AD and 20% were not; 80% of both groups also received mood-stabilizers. We evaluated factors associated with AD-treatment using bivariate analyses and multiple logistic-regression modeling.

RESULTS

Factors associated with AD-use by multivariate modeling ranked: [a] more years ill, [b] depressive first-lifetime episode, [c] more depressions/year, [d] melancholic index episode, and [e] less affective illness in first-degree relatives. Within 8weeks, depression improved by ≥50%, less often among BPD patients given an AD (64.4%; 38.6% without switching into hypo/mania) than not (82.1%; 78.6% without switching).

CONCLUSIONS

Use of ADs to treat acute BP-depression was very common and associated with a more severe clinical history. Mood-switching was prevalent with AD-treatment even with mood-stabilizers present.

摘要

背景

抗抑郁药（ADs）在治疗或预防双相障碍（BPD）患者的抑郁发作方面的疗效和耐受性，以及使用它们的原因，仍未得到解决。

方法

我们分析了巴塞罗那 Clinic 医院 290 名成年 DSM-IV BPD 患者（71%为 I 型，52%为女性）急性重度抑郁症发作的患者特征和结局；80%的患者使用了 AD，20%的患者未使用；两组中 80%的患者还接受了情绪稳定剂治疗。我们使用双变量分析和多元逻辑回归模型评估了与 AD 治疗相关的因素。

结果

多变量建模与 AD 使用相关的因素依次为：[a]患病年限较长，[b]首次发作抑郁，[c]每年抑郁发作次数较多，[d]忧郁指数发作，以及[e]一级亲属中情感障碍较少。在 8 周内，抑郁改善≥50%的患者，接受 AD 治疗的 BPD 患者较少（64.4%；38.6%未转为轻躁狂/躁狂），而非 AD 治疗的患者较多（82.1%；78.6%未转为轻躁狂/躁狂）。