Servicio de Psiquiatría, Departamento de Salud de la Ribera, Av. Santos Patronos 24, 8°, 29(a), 46.600 Alzira, Valencia, Spain.
Teaching Unit of Psychiatry, Department of Medicine, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain.
J Affect Disord. 2018 Dec 1;241:356-359. doi: 10.1016/j.jad.2018.08.001. Epub 2018 Aug 4.
The concept of Predominant Polarity (PP) provides relevant information for clinical practice and has been widely described as course specifier for Bipolar Disorder (BD), however it has not been incorporated in DSM-5 yet. A descriptive study was conducted to identify clinical patterns associated with PP in outpatients attending a Mental Health Unit.
Clinical and socio-demographic characteristics were assessed from a sample of 118 euthymic outpatients fulfilling DSM 5 criteria for BDI or II recruited at a catchment area. According to their PP, patients were divided into three subgroups: depressive (DPP; 39.0%), manic (MPP; 32.2%) or indeterminate (IPP; 28.8%). Subgroups of PP were compared regarding a comprehensive set of demographic and clinical features.
PP subgroups significantly differed in duration of euthymia, measured in months since the last episode (p < 0.04), with MMP patients showing longer periods (42.4 months) than those with DPP and IPP (18.6 and 18.1 months, respectively). Moreover, history of seasonal pattern was significantly higher in the DPP group compared with the PPM group (p < 0.001). There were no significant correlations between PP and type of last episode, length of illness, number of previous admissions, history of psychotic symptoms, or number of suicide attempts.
Cross sectional design, relatively modest sample size.
Our study showed similar results to previous literature regarding distribution of predominant polarity. The association found between PP and duration of euthymia represents a novel finding which awaits confirmation and adds further support to the usefulness of PP in clinical practice.
主导极性（PP）的概念为临床实践提供了相关信息，并且已经被广泛描述为双相障碍（BD）的病程特征，但尚未被纳入 DSM-5。本研究旨在通过对一个在精神卫生单位就诊的心境稳定门诊患者样本进行描述性研究，以确定与 PP 相关的临床模式。
对符合 DSM-5 双相 I 或 II 型诊断标准的 118 名心境稳定门诊患者的临床和社会人口学特征进行评估。根据他们的 PP，患者被分为三组：抑郁主导型（DPP；39.0%）、躁狂主导型（MPP；32.2%）或不确定主导型（IPP；28.8%）。对各组 PP 患者的人口统计学和临床特征进行比较。
PP 亚组在自上次发作以来的无躁狂期持续时间（以月为单位）方面存在显著差异（p<0.04），其中 MPP 患者的无躁狂期持续时间（42.4 个月）长于 DPP 患者（18.6 个月）和 IPP 患者（18.1 个月）。此外，DPP 组的季节性模式史明显高于 MPP 组（p<0.001）。PP 与最后一次发作的类型、发病时间、住院次数、精神病性症状史或自杀企图次数均无显著相关性。
横断面设计，样本量相对较小。
本研究结果与之前关于主导极性分布的文献相似。PP 与无躁狂期持续时间之间的关联是一个新发现，有待进一步确认，并为 PP 在临床实践中的有用性提供了更多支持。
