Azorin Jean-Michel, Belzeaux Raoul, Adida Marc
Department of Psychiatry, Sainte-Marguerite Hospital, 270 Bd Sainte Marguerite, 13274 Marseille Cedex 9, France.
Department of Psychiatry, Sainte-Marguerite Hospital, 270 Bd Sainte Marguerite, 13274 Marseille Cedex 9, France.
Behav Brain Res. 2015 Apr 1;282:185-93. doi: 10.1016/j.bbr.2015.01.014. Epub 2015 Jan 14.
Depressive illnesses with subthreshold bipolar features are still misdiagnosed as unipolar. The goal of this study was to identify depressive disorder subtypes at risk for bipolarity. Four hundred ninety three major depressive patients were submitted to a cluster analysis on the basis of affective illness history and symptoms of the current episode. Seven clusters were identified which were regrouped into three age-at-onset subgroups; subgroups were further differentiated into subtypes according to predominant comorbidities. The latter were found to precede the occurrence of the related depressive disorder subtypes, decrease their age-at-onset, and increase their risk of belonging to the bipolar spectrum: the earlier the comorbidity, the higher the bipolar propensity was. This is likely to have implications for the diagnosis, natural history, as well as prophylaxis of bipolar disorders.
具有阈下双相特征的抑郁性疾病仍被误诊为单相抑郁。本研究的目的是识别有双相情感障碍风险的抑郁症亚型。493名重度抑郁症患者根据情感疾病史和当前发作症状进行聚类分析。识别出7个聚类，这些聚类被重新划分为3个发病年龄亚组；亚组根据主要共病情况进一步分为不同亚型。发现后者先于相关抑郁症亚型的出现，降低其发病年龄，并增加其属于双相谱系的风险：共病出现得越早，双相倾向越高。这可能对双相情感障碍的诊断、自然病程以及预防产生影响。
