Stone K
Department of Psychiatry, Central Manchester Health Authority, Manchester Royal Infirmary.
Br J Psychiatry. 1989 Aug;155:220-4. doi: 10.1192/bjp.155.2.220.
A retrospective study of 92 patients admitted with mania, aged over 65 years of age, found that 26% had no prior history of affective illness; 30% had previously only experienced depression, and half of these had at least three episodes of depression before the first manic illness. Patients with a family history of affective disorders had a significantly earlier age of onset of illness. There was evidence of cerebral organic impairment in 24% of the patients, and this group had a significantly later age of onset of illness. Prognosis was good, with only 8% still in hospital at six months. Half of the patients were started on lithium prophylaxis, but this did not significantly alter the number of readmissions. A quarter of those started on lithium developed evidence of lithium toxicity.
一项对92名65岁以上因躁狂症入院患者的回顾性研究发现，26%的患者既往无情感障碍病史；30%的患者此前仅经历过抑郁症，其中一半患者在首次躁狂发作前至少有三次抑郁发作。有情感障碍家族史的患者发病年龄显著更早。24%的患者有脑器质性损害的证据，该组患者发病年龄显著更晚。预后良好，六个月时仅有8%的患者仍住院。一半的患者开始接受锂盐预防性治疗，但这并未显著改变再次入院的人数。开始使用锂盐治疗的患者中有四分之一出现锂中毒的迹象。
