Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305 USA ; Department of Neuroscience, Research Center in Neuroscience and Neuropsychology, Universidad de Palermo, Mario Bravo 1259, C1175ABT Buenos Aires, Argentina.
Department of Neuroscience, Research Center in Neuroscience and Neuropsychology, Universidad de Palermo, Mario Bravo 1259, C1175ABT Buenos Aires, Argentina.
Int J Bipolar Disord. 2015 Apr 24;3:8. doi: 10.1186/s40345-015-0027-z. eCollection 2015.
Bipolar disorder presents with diverse clinical manifestations. Numerous investigators have sought to identify variables that may predict a more severe illness course.
With the objective of studying the clinical characteristics of bipolar patients between South and North America, a comparison was performed between a sample from Argentina (n = 449) and a sample from the United States (n = 503) with respect to demographics and clinical characteristics, including presence of comorbidities.
The Argentinian sample had more unfavorable demographics and higher rates of prior psychiatric hospitalization and prior suicide attempt but a better social outcome. However, the sample from the United States had a higher rate of prior year rapid cycling, as well as younger bipolar disorder onset age (mean ± SD, 17.9 ± 8.4 vs. 27.1 ± 11.4 years) and more severe clinical morbidity, though there was no significant difference in terms of the total duration of the illness. Argentinian compared to American patients were taking more mood stabilizers and benzodiazepines/hypnotics, but fewer antipsychotics and other psychotropic medications, when considering patients in aggregate as well as when stratifying by illness subtype (bipolar I versus bipolar II) and by illness onset age (≤21 vs. >21 years). However, there was no significant difference in rate of antidepressant prescription between the two samples considered in aggregate.
Although possessing similar illness durations, these samples presented significant clinical differences and distinctive prescription patterns. Thus, though the Argentinian compared to North American patients had more unfavorable demographics, they presented a better social outcome and, in several substantive ways, more favorable illness characteristics. In both samples, early onset (age ≤ 21 years) was a marker for poor prognosis throughout the illness course, although this phenomenon appeared more robust in North America.
双相情感障碍表现出多种临床表现。许多研究人员试图确定可能预测更严重疾病过程的变量。
为了研究南、北美洲的双相患者的临床特征，对来自阿根廷的样本（n=449）和来自美国的样本（n=503）进行了比较，比较了人口统计学和临床特征，包括合并症的存在。
阿根廷样本的人口统计学特征更差，精神病住院和自杀未遂的比例更高，但社会结局更好。然而，美国样本的前一年快速循环率更高，双相障碍发病年龄更年轻（均值±标准差，17.9±8.4 岁比 27.1±11.4 岁），临床发病率更严重，尽管总病程无显著差异。阿根廷患者比美国患者服用更多的心境稳定剂和苯二氮䓬类/催眠药，但服用更少的抗精神病药和其他精神药物，当考虑所有患者以及根据疾病亚型（双相 I 型与双相 II 型）和发病年龄（≤21 岁与>21 岁）分层时。然而，这两个样本在总人群中以及在疾病亚型和发病年龄分层时，抗抑郁药的处方率没有显著差异。
尽管这两个样本的病程相似，但它们表现出显著的临床差异和不同的处方模式。因此，尽管与北美患者相比，阿根廷患者的人口统计学特征较差，但他们的社会结局更好，而且在许多实质性方面，疾病特征更为有利。在这两个样本中，早发（年龄≤21 岁）是整个疾病过程预后不良的标志，尽管这一现象在北美更为明显。
