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心境障碍家族史提示更严重的双相障碍。

Family history of a mood disorder indicates a more severe bipolar disorder.

机构信息

Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.

Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.

出版信息

J Affect Disord. 2014 Mar;156:178-86. doi: 10.1016/j.jad.2013.12.013. Epub 2013 Dec 18.

Abstract

BACKGROUND

In the clinical setting, patients with bipolar disorder (BD) are often asked about potential family history (FH) of mood disorders. The aim of the present study was to examine differences between BD patients with FH of a mood disorder, and those without, on clinical, personality and social functioning characteristics, as well as on the symptomatic course of the disorder.

METHODS

Data was collected from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). For this report, we included 2600 patients, 1963 of those reported having a first-degree family member with a mood disorder, and 637 reported of no such FH. We investigated the impact of FH on socio-demographic, clinical, personality and quality of life variables, as well as on symptomatology during the first year of treatment.

RESULTS

Patients reporting FH of a mood disorder had an earlier age at onset of depression/mania, more phases, rapid cycling and more suicide attempts. Across different assessments, patients with FH showed consistently elevated depressive symptoms, such as lower concentration and energy, higher suicidal ideation, as well as increased racing thoughts and distractibility within the manic spectrum of symptoms. Further, the FH group had lower quality of life, higher neuroticism and higher personality disorder scores compared to patients without FH.

LIMITATIONS

Information on FH was obtained through the proband.

CONCLUSIONS

Overall, BD patients reporting FH of a mood disorder showed a worse clinical profile upon presentation for treatment and a more symptomatic course of the disorder.

摘要

背景

在临床环境中,经常会询问双相情感障碍(BD)患者是否存在心境障碍的家族史(FH)。本研究旨在研究有 FH 和无 FH 的 BD 患者在临床、人格和社会功能特征以及疾病的症状病程方面的差异。

方法

数据来自双相情感障碍的系统治疗增强计划(STEP-BD)。本报告纳入了 2600 名患者,其中 1963 名患者报告有一级亲属患有心境障碍,637 名患者报告无 FH。我们调查了 FH 对社会人口统计学、临床、人格和生活质量变量以及治疗第一年症状的影响。

结果

报告有 FH 的心境障碍的患者抑郁/躁狂的发病年龄更早,发作次数更多,快速循环更多,自杀企图更多。在不同的评估中,有 FH 的患者表现出持续升高的抑郁症状,如注意力和精力下降、自杀意念增加,以及在躁狂谱系症状中出现更多的思维奔逸和注意力不集中。此外,与无 FH 的患者相比,FH 组的生活质量更低,神经质和人格障碍得分更高。

局限性

FH 的信息是通过先证者获得的。

结论

总体而言,报告有 FH 的 BD 患者在就诊时表现出更差的临床特征和更严重的疾病症状病程。

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