Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto VA Health Care System, Palo Alto, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Department of Psychiatry, University of Milan; Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
J Affect Disord. 2014 Dec;169 Suppl 1:S3-11. doi: 10.1016/S0165-0327(14)70003-5.
Bipolar disorder is characterized by debilitating episodes of depression and mood elevation (mania or hypomania). For most patients, depressive symptoms are more pervasive than mood elevation or mixed symptoms, and thus have been reported in individual studies to impose a greater burden on affected individuals, caregivers, and society. This article reviews and compiles the literature on the prevalence and burden of syndromal as well as subsyndromal presentations of depression in bipolar disorder patients.
The PubMed database was searched for English-language articles using the search terms "bipolar disorder," "bipolar depression," "burden," "caregiver burden," "cost," "costs," "economic," "epidemiology," "prevalence," "quality of life," and "suicide." Search results were manually reviewed, and relevant studies were selected for inclusion as appropriate. Additional references were obtained manually from reviewing the reference lists of selected articles found by computerized search.
In aggregate, the findings support the predominance of depressive symptoms compared with mood elevation/mixed symptoms in the course of bipolar illness, and thus an overall greater burden in terms of economic costs, functioning, caregiver burden, and suicide.
This review, although comprehensive, provides a study-wise aggregate (rather than a patient-wise meta-analytic) summary of the relevant literature on this topic.
In light of its pervasiveness and prevalence, more effective and aggressive treatments for bipolar depression are warranted to mitigate its profound impact upon individuals and society. Such studies could benefit by including metrics not only for mood outcomes, but also for illness burden.
双相情感障碍的特征是衰弱性抑郁发作和情绪升高（躁狂或轻躁狂）。对于大多数患者来说，抑郁症状比情绪升高或混合症状更为普遍，因此在个别研究中报告称，这些症状对患者、护理人员和社会造成了更大的负担。本文综述和汇编了双相情感障碍患者中综合征和亚综合征抑郁的患病率和负担相关文献。
使用“bipolar disorder”、“bipolar depression”、“burden”、“caregiver burden”、“cost”、“costs”、“economic”、“epidemiology”、“prevalence”、“quality of life”和“suicide”等术语，在 PubMed 数据库中搜索英文文献。手动审查搜索结果，并选择适当的相关研究纳入。从计算机检索到的选定文章的参考文献列表中手动获取其他参考文献。
总的来说，这些发现支持在双相情感障碍病程中，抑郁症状比情绪升高/混合症状更为常见，因此在经济成本、功能、护理人员负担和自杀方面存在更大的总体负担。
尽管本综述全面，但它提供了该主题相关文献的研究级综合（而非患者级荟萃分析）总结。
鉴于其普遍性和普遍性，需要更有效和积极的双相情感障碍治疗方法来减轻其对个人和社会的深远影响。此类研究可以受益于不仅包括情绪结果的指标，还包括疾病负担的指标。
