Breslau N, Meltzer H Y
Department of Psychiatry, Case Western Reserve School of Medicine, Cleveland.
Am J Psychiatry. 1988 Jan;145(1):35-40. doi: 10.1176/ajp.145.1.35.
The authors examine the validity of subtyping psychotic depression by comparing 111 patients with schizoaffective, unipolar, and bipolar psychotic depression on demographic characteristics and symptoms at index episode. Diagnoses were made by using Research Diagnostic Criteria (RDC). The three groups were indistinguishable in sex, race, and age at onset. Schizoaffective patients had more "schizophrenic" symptoms but were not different in depressive delusions, other psychotic symptoms, or affective symptoms. However, bipolar patients scored significantly higher than nonbipolar patients on hypomania. There is little support in these data for the schizoaffective versus nonschizoaffective distinction. Further tests are needed, including tests of response to treatment and biological markers.
作者通过比较111例患有分裂情感性、单相和双相精神病性抑郁症的患者在发病时的人口统计学特征和症状，来检验精神病性抑郁症亚型分类的有效性。诊断采用研究诊断标准（RDC）。三组在性别、种族和发病年龄方面没有差异。分裂情感性患者有更多“精神分裂症”症状，但在抑郁性妄想、其他精神病性症状或情感症状方面并无不同。然而，双相患者在轻躁狂方面的得分显著高于非双相患者。这些数据几乎不支持分裂情感性与非分裂情感性的区分。还需要进一步的测试，包括对治疗反应和生物标志物的测试。
