Bram Nessrine, Elloumi Hend, Zalila Haifa, Cheour Majda, Boussetta Afif
Hôpital Razi, Manouba Tunise, Faculté de Médecine de Tunis, Université Tunis El Manar.
Tunis Med. 2012 May;90(5):380-6.
The polarity of the inaugural episode seems to determine the clinical and evolutionary profile of bipolar disorder.
To study the clinical and evolutionary characteristics bipolar disorder according to the polarity of the first episode.
We undertook a retrospective, descriptive and comparative study including all the patients reached of bipolar disorder I and II (DSM IV TR) who were hospitalized between January 1 2000 and December 31 2006. The minimal duration of follow-up was 4 years. Patients were divided into two groups according to the polarity of the first episode: maniac or hypomaniaque and depressive. The characteristics sociodemographic, clinical, evolutionary and therapeutic were raised and compared between the two groups.
The sample was composed of 38 patients (23 men and 15 women). The first episode was of polarity maniac in 57.89% of cases. This mode of beginning was related to a later polarity preferentially maniac, more often punctuated of characteristics psychotics with a sur representation of the addictives conduits and bipolar disorder of type I an episode index of depressive polarity was associated to more chronic evolution, marked by a stronger recurrence of episodes particularly depressive episodes, with a raised suicidal risk and a high representation of the bipolar disorder II.
The clinical and evolutionary profile of the bipolar disorder seems strongly related to the polarity of the first episode. The strategies of prevention must take account of the inaugural polarity.
首发发作的极性似乎决定了双相情感障碍的临床和演变特征。
根据首发发作的极性研究双相情感障碍的临床和演变特征。
我们进行了一项回顾性、描述性和比较性研究，纳入了2000年1月1日至2006年12月31日期间住院的所有符合双相I型和II型障碍（DSM-IV-TR）的患者。最短随访时间为4年。根据首发发作的极性将患者分为两组：躁狂或轻躁狂发作组和抑郁发作组。比较两组患者的社会人口学、临床、演变和治疗特征。
样本由38例患者组成（23例男性和15例女性）。57.89%的病例首发发作为躁狂极性。这种起病方式与更晚出现的极性（优先为躁狂）相关，更常伴有精神病性特征，成瘾途径的比例过高，I型双相情感障碍更为常见。抑郁极性的发作指数与更慢性的演变相关，其特点是发作尤其是抑郁发作的复发更强，自杀风险增加，II型双相情感障碍的比例较高。
双相情感障碍的临床和演变特征似乎与首发发作的极性密切相关。预防策略必须考虑首发极性。
