Woo Young Sup, Shim In Hee, Wang Hee-Ryung, Song Hoo Rim, Jun Tae-Youn, Bahk Won-Myong
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological & Medical Sciences, Busan, Republic of Korea.
J Affect Disord. 2015 Mar 15;174:83-8. doi: 10.1016/j.jad.2014.11.034. Epub 2014 Nov 26.
The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria.
The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study.
The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion.
This study was conducted using a retrospective design and did not include structured diagnostic interviews.
The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients.
本研究的主要目的是确定可能预测从重度抑郁症（MDD）转换为双相情感障碍（BP）的因素，并评估双相谱系障碍（BPSD）诊断标准的预测性能。
本研究对250例诊断为MDD至少5年的患者的病历进行了回顾性分析。
在250例MDD患者中，18.4%出现了从MDD到BP的诊断转换，BPSD诊断标准对这种转换的预测具有高敏感性（0.870）和特异性（0.917）。BP家族史、抗抑郁药诱发的躁狂/轻躁狂、短暂的重度抑郁发作、发病年龄早、抗抑郁药失效和抗抑郁药抵抗也是这种转换的独立预测因素。
本研究采用回顾性设计，未包括结构化诊断访谈。
BPSD诊断标准对从MDD转换为BP具有高度预测性，且转换与BPSD的几种临床特征相关。因此，BPSD诊断标准可能有助于预测MDD患者的双相素质。
