Universidade Católica de Pelotas, Rua Félix da Cunha, 412 Pelotas, 96010-000 Pelotas, RS, Brazil.
J Affect Disord. 2012 Dec 15;142(1-3):208-12. doi: 10.1016/j.jad.2012.04.028. Epub 2012 Sep 7.
The objective of this report is to evaluate functioning in bipolar disorder in a population-based sample of young adults (18 to 24 years old). To this end, people with bipolar disorder were compared with matched participants with only depressive episodes and control subjects without a history of mood episodes.
Case-control study nested in a population-based sample. Caseness was confirmed with the Structured Clinical Interview for DSM-IV. The Functioning Assessment Short Test was used as a measure of general functioning. A multivariate model was elaborated to account for potential confounders.
The sample consisted of 231 subjects. Both bipolar disorder (coef=0.60, SE=0.14, p<0.001) and major depression (coef=0.44, SE=0.14, p=0.001) were associated with functioning in the multivariate model. Current depressive symptoms appeared to influence functioning in those with major depression (Z=2.05, p=0.04), but not in those with bipolar disorder (Z=0.78, p=0.43).
Neuropsychological testing was not performed and we see it as an important limitation of this study.
This population-based study further reinforces the notion that functional impairment is a fundamental characteristic of bipolar illness. It is present from early stages and is not completely explained by mood symptoms.
本报告的目的是评估年轻成年人（18 至 24 岁）人群中双相情感障碍的功能。为此，将双相情感障碍患者与仅患有抑郁发作的匹配参与者和无心境发作史的对照组进行比较。
巢式病例对照研究，基于人群的样本。使用 DSM-IV 结构化临床访谈来确认病例。使用功能评估简短测试作为一般功能的衡量标准。制定了一个多变量模型来解释潜在的混杂因素。
样本包括 231 名受试者。双相情感障碍（系数=0.60，SE=0.14，p<0.001）和重度抑郁症（系数=0.44，SE=0.14，p=0.001）均与多变量模型中的功能相关。当前的抑郁症状似乎影响了患有重度抑郁症的人的功能（Z=2.05，p=0.04），但对患有双相情感障碍的人没有影响（Z=0.78，p=0.43）。
未进行神经心理学测试，我们认为这是该研究的一个重要局限性。
这项基于人群的研究进一步强化了功能障碍是双相情感障碍的基本特征这一观点。它从早期就存在，并且不能完全由情绪症状来解释。
