双相障碍患者的短暂抑郁症状：长期自我报告数据的分析。

Brief depressive symptoms in patients with bipolar disorder: analysis of long-term self-reported data.

机构信息

Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany.

出版信息

Aust N Z J Psychiatry. 2012 Nov;46(11):1068-78. doi: 10.1177/0004867412452017. Epub 2012 Jun 25.

DOI:10.1177/0004867412452017

PMID:22734088

Abstract

OBJECTIVE

Most patients with bipolar disorder experience depressive symptoms outside of an episode of depression as defined by DSM-IV criteria. This study explores the frequency of brief depressive episodes, lasting 1 to 4 days, using daily self-reported mood ratings.

METHOD

Mood ratings were obtained from 448 patients (281 bipolar I, 167 bipolar II) using ChronoRecord software (91,786 total days). Episodes of depression and days of depression outside of episodes were determined. The intensity of depressive symptoms (mild versus moderate to severe) was compared.

RESULTS

Using the DSM-IV length criteria, 61% of all depressive days occurred outside of a depressed episode. Decreasing the minimum length criterion to 2 days, both the number of patients experiencing a depressed episode (128 to 317) and the mean percent of days spent in a depressed episode by each patient (7.9% to 17.8.%) increased by about 2½ times, and 34.3% of depressed days remained outside of an episode. Depending on the episode length, the proportion of days within an episode with severe symptoms varied from 1/3 to 1/4 for episodes lasting from 14 to 2 days, and 1/4 for single-day episodes. There was no significant difference in the frequency of brief depressive episodes between bipolar I and II disorders. For all episode lengths, patients taking antidepressants spent 4% more days within an episode and 6% more days with depressive symptoms outside of an episode than those not taking antidepressants.

CONCLUSION

Brief depressive episodes lasting 1 to 4 days occur frequently in bipolar disorder and do not distinguish between bipolar I and II disorders. Symptoms of moderate to severe intensity occur on 1/4 to 1/3 of the days in brief depressive episodes. This study did not address brief depression in those without bipolar disorder. Patients taking antidepressants experienced more brief depressive episodes. Controlled trials are needed to assess the impact of antidepressants on subsyndromal depressive symptoms.

摘要

目的

大多数双相情感障碍患者在经历 DSM-IV 标准定义的抑郁发作之外会出现抑郁症状。本研究使用每日自我报告的情绪评分来探讨持续 1 至 4 天的短暂抑郁发作的频率。

方法

使用 ChronoRecord 软件（共 91786 天）从 448 名患者（281 名双相 I 型，167 名双相 II 型）中获得情绪评分。确定抑郁发作和发作外的抑郁天数。比较抑郁症状的强度（轻度与中重度）。

结果

使用 DSM-IV 长度标准，所有抑郁天数的 61%发生在抑郁发作之外。将最短长度标准降低到 2 天，经历抑郁发作的患者数量（从 128 到 317）和每位患者在抑郁发作中度过的平均天数百分比（从 7.9%到 17.8%）增加了约 2 倍半，34.3%的抑郁天数仍在发作之外。根据发作长度，持续 14 至 2 天的发作中严重症状的天数比例从 1/3 到 1/4，而持续 1 天的发作中为 1/4。在所有发作长度下，服用抗抑郁药的患者在发作期间内度过的天数比不服用抗抑郁药的患者多 4%，在发作外的抑郁天数多 6%。双相 I 型和 II 型障碍之间短暂抑郁发作的频率没有差异。对于所有发作长度，服用抗抑郁药的患者在发作期间内度过的天数比不服用抗抑郁药的患者多 4%，在发作外的抑郁天数多 6%。本研究未探讨无双相障碍患者的短暂抑郁。服用抗抑郁药的患者经历了更多的短暂抑郁发作。需要对照试验来评估抗抑郁药对亚综合征抑郁症状的影响。