Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States; NESMOS Department of Psychiatry, Sant׳Andrea Medical Center, Sapienza University of Rome, Italy.
Department of Psychiatry, Harvard Medical School, Boston, MA, United States; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, Belmont, MA, United States.
J Affect Disord. 2015 Jun 1;178:71-8. doi: 10.1016/j.jad.2015.02.011. Epub 2015 Mar 3.
Long-term symptomatic status in persons with major depressive and bipolar disorders treated clinically is not well established, although mood disorders are leading causes of disability worldwide.
To pool data on long-term morbidity, by type and as a proportion of time-at-risk, based on published studies and previously unreported data.
We carried out systematic, computerized literature searches for information on percentage of time in specific morbid states in persons treated clinically and diagnosed with recurrent major depressive or bipolar I or II disorders, and incorporated new data from one of our centers.
We analyzed data from 25 samples involving 2479 unipolar depressive and 3936 bipolar disorder subjects (total N=6415) treated clinically for 9.4 years. Proportions of time ill were surprisingly and similarly high across diagnoses: unipolar depressive (46.0%), bipolar I (43.7%), and bipolar II (43.2%) disorders, and morbidity was predominantly depressive: unipolar (100%), bipolar-II (81.2%), bipolar-I (69.6%). Percent-time-ill did not differ between UP and BD subjects, but declined significantly with longer exposure times.
The findings indicate that depressive components of all major affective disorders accounted for 86% of the 43-46% of time in affective morbidity that occurred despite availability of effective treatments. These results encourage redoubled efforts to improve treatments for depression and adherence to their long-term use.
尽管心境障碍是全球范围内导致残疾的主要原因，但临床上治疗的重度抑郁和双相情感障碍患者的长期症状状况尚不清楚。
基于已发表的研究和以前未报告的数据，汇总关于特定病态类型和发病时间比例的长期发病率数据。
我们进行了系统的计算机文献检索，以获取关于在特定病态状态下处于特定病态状态的时间百分比的信息，这些患者接受过临床治疗，被诊断为复发性重度抑郁或双相 I 或 II 障碍，并纳入了我们中心的新数据。
我们分析了来自 25 个样本的数据，这些样本涉及 2479 名单相抑郁和 3936 名双相情感障碍患者（总计 N=6415），这些患者接受了 9.4 年的临床治疗。各诊断组的患病时间比例都高得惊人且相似：单相抑郁（46.0%）、双相 I（43.7%）和双相 II（43.2%）障碍，且发病率主要为抑郁：单相（100%）、双相 II（81.2%）、双相 I（69.6%）。单相和双相情感障碍患者的发病时间比例无差异，但随着暴露时间的延长，显著下降。
这些发现表明，所有主要情感障碍的抑郁成分占 43-46%的情感发病率的 86%，尽管有有效的治疗方法，但这些患者仍处于发病状态。这些结果鼓励加倍努力改善抑郁治疗方法和坚持长期使用。
