Dervic K, Garcia-Amador M, Sudol K, Freed P, Brent D A, Mann J J, Harkavy-Friedman J M, Oquendo M A
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY 10032, New York, USA; Department of Psychiatry and Behavioral Science, College of Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
Eur Psychiatry. 2015 Jan;30(1):106-13. doi: 10.1016/j.eurpsy.2014.06.005. Epub 2014 Oct 1.
To investigate distinguishing features between bipolar I, II and unipolar depression, and impulsivity/aggression traits in particular.
Six hundred and eighty-five (n=685) patients in a major depressive episode with lifetime Unipolar (UP) depression (n=455), Bipolar I (BP-I) disorder (n=151), and Bipolar II (BP-II) (n=79) disorder were compared in terms of their socio-demographic and clinical characteristics.
Compared to unipolar patients, BP-I and BP-II depressed patients were significantly younger at onset of their first depressive episode, and were more likely to experience their first depressive episode before/at age of 15. They also had more previous affective episodes, more first- and second-degree relatives with history of mania, more current psychotic and subsyndromal manic symptoms, and received psychopharmacological and psychotherapy treatment at an earlier age. Furthermore, BP-I and BP-II depressed patients had higher lifetime impulsivity, aggression, and hostility scores. With regard to bipolar subtypes, BP-I patients had more trait-impulsivity and lifetime aggression than BP-II patients whereas the latter had more hostility than BP-I patients. As for co-morbid disorders, Cluster A and B Personality Disorders, alcohol and substance abuse/dependence and anxiety disorders were more prevalent in BP-I and BP-II than in unipolar patients. Whereas the three groups did not differ on other socio-demographic variables, BP-I patients were significantly more often unemployed that UP patients.
Our findings comport with major previous findings on differences between bipolar and unipolar depression. As for trait characteristics, bipolar I and II depressed patients had more life-time impulsivity and aggression/hostility than unipolar patients. In addition, bipolar I and II patients also differed on these trait characteristics.
研究双相I型、II型障碍与单相抑郁之间的区别特征，尤其关注冲动性/攻击性特质。
比较685例重度抑郁发作患者，其中终生单相（UP）抑郁患者455例、双相I型（BP-I）障碍患者151例、双相II型（BP-II）障碍患者79例，比较他们的社会人口学和临床特征。
与单相抑郁患者相比，BP-I型和BP-II型抑郁患者首次抑郁发作时年龄显著更小，且更有可能在15岁之前/时经历首次抑郁发作。他们既往有更多情感发作，有更多有躁狂病史的一级和二级亲属，当前有更多精神病性和亚综合征躁狂症状，且更早接受心理药物治疗和心理治疗。此外，BP-I型和BP-II型抑郁患者终生冲动性、攻击性和敌意得分更高。关于双相亚型，BP-I型患者比BP-II型患者有更多特质冲动性和终生攻击性，而后者比BP-I型患者有更多敌意。至于共病障碍，A组和B组人格障碍、酒精和物质滥用/依赖以及焦虑症在BP-I型和BP-II型患者中比在单相抑郁患者中更常见。虽然三组在其他社会人口学变量上无差异，但BP-I型患者失业的频率显著高于UP型患者。
我们的研究结果与之前关于双相抑郁和单相抑郁差异的主要研究结果一致。就特质特征而言，BP-I型和BP-II型抑郁患者比单相抑郁患者有更多终生冲动性和攻击性/敌意。此外，BP-I型和BP-II型患者在这些特质特征上也存在差异。
