Datto Catherine, Pottorf William J, Feeley Louisa, LaPorte Scott, Liss Charlie
AstraZeneca, US Medical Affairs, 1800 Concord Pike, C2C-522, Wilmington, DE 19850 USA.
Ann Gen Psychiatry. 2016 Mar 11;15:9. doi: 10.1186/s12991-016-0096-0. eCollection 2016.
Bipolar I and II represent the most common and severe subtypes of bipolar disorder. Although bipolar I disorder is relatively well studied, the clinical characteristics and response to treatment of patients with bipolar II disorder are less well understood.
To compare the severity and burden of illness of patients with bipolar II versus bipolar I disorder, baseline demographic, clinical, and quality of life data were examined in 1900 patients with bipolar I and 973 patients with bipolar II depression, who were enrolled in five similarly designed clinical placebo-controlled trials of quetiapine immediate-release and quetiapine extended-release. Acute (8 weeks) response to treatment was also compared by assessing rating scale scores, including Montgomery-Åsberg depression rating scale, Hamilton rating scale for anxiety, Young mania rating scale, and clinical global impression-severity scores, in the bipolar I and II populations in the same pooled database.
Patients with bipolar I and bipolar II depression were similar in demographics, baseline rating scale scores (depression, anxiety, mania, and quality of life), and mood episode histories. Symptom improvements in response to quetiapine were greater versus comparators (lithium, paroxetine, and placebo) at 4 and 8 weeks in both bipolar I and II patients. Patients with the bipolar II subtype initially showed slower responses to all treatments, but, by 8 weeks, attained similar symptom improvement as patients with bipolar I depression.
Pooled analysis of five clinical trials of quetiapine demonstrated that patients with bipolar II depression have a similar burden of illness and quality of life to patients with bipolar I. Bipolar II patients consistently showed a slower response to treatments than bipolar I patients, but, after 8 weeks of treatment with quetiapine, symptom improvements were similar between bipolar I and II disorder subtypes.
双相I型和II型是双相情感障碍最常见且最严重的亚型。尽管双相I型障碍已得到较为充分的研究，但双相II型障碍患者的临床特征及治疗反应仍了解较少。
为比较双相II型与双相I型障碍患者的疾病严重程度和负担，对1900例双相I型患者和973例双相II型抑郁患者的基线人口统计学、临床及生活质量数据进行了检查，这些患者参与了五项设计相似的关于喹硫平速释片和缓释片的临床安慰剂对照试验。在同一汇总数据库中，通过评估双相I型和II型人群的量表评分，包括蒙哥马利-艾斯伯格抑郁量表、汉密尔顿焦虑量表、杨氏躁狂量表及临床总体印象-严重程度评分，对治疗的急性（8周）反应也进行了比较。
双相I型和双相II型抑郁患者在人口统计学、基线量表评分（抑郁、焦虑、躁狂及生活质量）和情绪发作史方面相似。在双相I型和II型患者中，与对照药物（锂盐、帕罗西汀和安慰剂）相比，喹硫平在4周和8周时带来的症状改善更显著。双相II型亚型患者最初对所有治疗的反应较慢，但到8周时，症状改善程度与双相I型抑郁患者相似。
对五项喹硫平临床试验的汇总分析表明，双相II型抑郁患者与双相I型患者的疾病负担和生活质量相似。双相II型患者对治疗的反应始终比双相I型患者慢，但在用喹硫平治疗8周后，双相I型和II型障碍亚型之间的症状改善相似。
