School of Psychiatry, University of New South Wales, NSW, Australia.
J Affect Disord. 2013 Aug 15;150(1):50-6. doi: 10.1016/j.jad.2013.02.018. Epub 2013 Mar 13.
Risk-taking behaviours during hypomanic states are recognised, however the high-risk nature of some behaviours-including the potential for harm to both the individual and others-has not been detailed in the research literature. The current study examines risk-taking behaviours and their consequences (including their potential for impairment) in those with a bipolar II condition.
Participants were recruited from the Sydney-based Black Dog Institute Depression Clinic. Diagnostic assignment of bipolar II disorder was based on clinician judgement and formal DSM-IV criteria. Participants completed a series of detailed questions assessing previous risk-taking behaviours during hypomanic states.
The sample comprised a total of 93 participants. Risk-taking behaviours during hypomania included spending significant amounts of money, excessive alcohol or drug use, dangerous driving and endangering sexual activities. Key consequences included interpersonal conflict, substantial financial burden and feelings of guilt, shame and remorse. Despite recognition of the risks and consequences associated with hypomanic behaviours, less than one-fifth of participants agreed that hypomania should be treated because of the associated risks.
Study limitations included a cross-sectional design, reliance on self-report information, lack of controlling for current mood state, and comprised a tertiary referral sample that may be weighted to more severe cases. Findings may therefore not be generalisable and require replication.
Risk-taking behaviours during hypomania are common, and often linked with serious consequences. Whilst hypomania is often enjoyed and romanticised by patients-leading to ambivalence around treatment of such states-careful consideration of the impact of risk-taking behaviour is necessary, while the study raises the question as to what is 'impairment' in hypomania. Findings should advance clinical management by identifying those high-risk behaviours that would benefit from pre-emptive weighting in developing individual's wellbeing plans for managing the condition.
人们已经认识到在轻躁狂状态下存在冒险行为，但一些行为的高风险性，包括对个人和他人造成伤害的潜在风险，在研究文献中并未详细说明。本研究考察了双相情感障碍 II 型患者在轻躁狂状态下的冒险行为及其后果（包括其潜在的损害）。
参与者从位于悉尼的黑狗研究所抑郁症诊所招募。双相情感障碍 II 型的诊断分配基于临床医生的判断和正式的 DSM-IV 标准。参与者完成了一系列详细的问题，评估他们在轻躁狂状态下的以往冒险行为。
该样本共包括 93 名参与者。轻躁狂期间的冒险行为包括大量花钱、过度饮酒或吸毒、危险驾驶和危险性行为。主要后果包括人际关系冲突、巨大的经济负担以及内疚、羞耻和悔恨的感觉。尽管认识到与轻躁狂行为相关的风险和后果，但不到五分之一的参与者同意因为相关风险而对轻躁狂进行治疗。
研究的局限性包括横断面设计、依赖自我报告信息、缺乏对当前情绪状态的控制，以及样本来自三级转诊机构，可能偏向更严重的病例。因此，研究结果可能不具有普遍性，需要进一步验证。
轻躁狂期间的冒险行为很常见，通常与严重后果相关。尽管轻躁狂常常被患者所享受和浪漫化，导致对治疗这种状态的矛盾态度，但需要仔细考虑冒险行为的影响，同时研究提出了在轻躁狂中什么是“损害”的问题。研究结果通过确定那些需要预先预防的高风险行为，为制定个体管理病情的幸福感计划提供了参考，从而有助于临床管理。
