School of Psychiatry, University of New South Wales, Sydney, Australia.
J Affect Disord. 2013 Mar 5;145(3):336-40. doi: 10.1016/j.jad.2012.08.014. Epub 2012 Sep 12.
The detection of early warning signs is a major component of many psychological interventions for assisting in the management of bipolar disorder. The aim of this study was to assess whether the ability to detect early warning signs was associated with clinical and demographic characteristics in a bipolar disorder clinic sample.
Two-hundred-and-one participants with DSM-IV bipolar I or II disorder aged over 18 years of age were recruited through a specialized bipolar disorder clinic. Participants were administered a structured interview by psychiatrists asking participants about any early warning signs, and features of the phenomenology, course and treatment of bipolar disorder.
Participants were significantly more likely to recognise both hypo/manic and depressive early warning signs rather than only one type of mood episode. The ability to detect signs of both hypo/mania and depression was greater in younger participants. The ability to detect signs of depression was associated with more prior depressive episodes and a lesser likelihood of prior hospitalisations whilst a history of mixed mood was associated with a greater likelihood of detecting depressive symptoms. The ability to recognise signs of hypo/mania was greater in those reporting a history of visual hallucinations (during depressive and/or manic episodes).
Cross-sectional design and previous experience with psychotherapy was not assessed.
These findings provide useful clinical data pertinent to psychological interventions for bipolar disorder. Longitudinal studies are needed to further examine how the ability to recognise early warning signs may be associated with longer term outcome.
预警信号的检测是许多心理干预措施的重要组成部分，有助于双相情感障碍的管理。本研究旨在评估在双相情感障碍临床样本中，检测预警信号的能力是否与临床和人口统计学特征相关。
通过专门的双相情感障碍诊所招募了 210 名年龄在 18 岁以上的 DSM-IV 双相 I 或 II 障碍患者。通过精神科医生对参与者进行结构化访谈，询问他们有关任何预警信号以及双相情感障碍的现象学、病程和治疗特征的信息。
参与者识别轻躁狂/躁狂和抑郁预警信号的可能性明显更高，而不仅仅是一种情绪发作。年轻参与者更有可能检测到轻躁狂/躁狂和抑郁的迹象。检测抑郁迹象的能力与更多的既往抑郁发作和较少的住院治疗可能性相关，而混合情绪的既往史与更有可能检测到抑郁症状相关。报告有视觉幻觉（在抑郁和/或躁狂发作期间）的患者，识别轻躁狂/躁狂迹象的能力更强。
横断面设计和以前的心理治疗经验未被评估。
这些发现为双相情感障碍的心理干预提供了有用的临床数据。需要进行纵向研究，以进一步研究识别预警信号的能力如何与长期结果相关。
