Kuppili Pooja Patnaik, Yadav Priyanka, Pattanayak Raman Deep
Senior Resident, Department of Psychiatry, JIPMER, Puducherry.
Senior Resident.
J Assoc Physicians India. 2017 Jul;65(7):80-84.
The bipolar spectrum is a broader concept, which questions the strict dichotomous categorical division of erstwhile manic-depressive illness into two discrete categories viz. bipolar disorder and major depressive disorder, thereby overlooking a wide 'spectrum' of patients which lie 'in between' the two extremes. The presence of underlying bipolar 'spectrum' or 'soft bipolarity' often goes undetected in patients presenting with major depression. This sub-group of patients may not stabilize with indiscriminate use of anti-depressant drugs, and without proper management, it may be associated with continued non-responsive symptoms, increased suicidality and poorer prognosis. There is a need to suspect and identify such cases of soft bipolarity/spectrum by early screening of patients with major depression presenting to medical settings. The review paper covers the current concepts and understanding of bipolar spectrum disorders which is aimed to facilitate early identification, management and referral of cases detected to have soft bipolarity in the general medical settings.
双相谱系是一个更宽泛的概念，它对以往将躁狂抑郁症严格二分法分类为双相情感障碍和重度抑郁症这两个离散类别提出了质疑，从而忽视了处于这两个极端之间的广大患者“谱系”。在表现为重度抑郁的患者中，潜在的双相“谱系”或“软双相性”常常未被察觉。这一亚组患者若不加区分地使用抗抑郁药物可能无法病情稳定，且若管理不当，可能会出现持续的无反应症状、自杀倾向增加及预后较差的情况。有必要通过对到医疗机构就诊的重度抑郁患者进行早期筛查，来怀疑并识别这类软双相性/谱系病例。这篇综述文章涵盖了双相谱系障碍的当前概念和理解，旨在促进在普通医疗环境中对检测出有软双相性的病例进行早期识别、管理和转诊。
