Steardo Luca, Carbone Elvira Anna, Ventura Enrica, de Filippis Renato, Luciano Mario, Segura-Garcia Cristina, De Fazio Pasquale
Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Psychiatric Unit, Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Front Psychiatry. 2021 Oct 25;12:732843. doi: 10.3389/fpsyt.2021.732843. eCollection 2021.
Dissociative symptoms are under recognized and scarcely studied by clinicians and researchers in patients with bipolar disorder (BD). We examined the relationship between dissociative symptoms and the psychotic features in patients with BD and assessed clinical and socio-demographic characteristics more frequently associated with dissociative symptoms and treatment response. Participants were 100 adult outpatients with BD. They were screened with semi-structured interview to collect socio-demographic and clinical characteristics; the Dissociative Experiences Scale-II (DES-II) and the ALDA scale were used to assess dissociative psychopathologies and response to treatment with mood stabilizers, respectively. DES score (mean 31.7 ± 21.7) correlated with clinical variables, BD features, and course of illness. Psychotic symptoms, mixed features, and previous suicide attempts significantly predicted DES score [ = 39.880, < 0.001, corrected = 0.713]. Dissociative symptoms were inversely correlated with poor response to treatment ( = -0.593; < 0.001). Cross-sectional design with a small sample and backward clinical assessment of psychotic symptoms. Dissociative phenomena are closely related to the presence of psychotic symptoms, mixed features, and previous suicide attempts in BD, especially in BD-I. Given the close association between dissociative and psychotic symptoms, this association could represent a diagnostic indicator of BD-I that may guide the clinician to plan the most appropriate treatment.
在双相情感障碍（BD）患者中，分离症状未得到充分认识，临床医生和研究人员对其研究也很少。我们研究了BD患者分离症状与精神病性特征之间的关系，并评估了更常与分离症状及治疗反应相关的临床和社会人口学特征。研究对象为100名成年BD门诊患者。通过半结构化访谈收集他们的社会人口学和临床特征；分别使用分离体验量表-II（DES-II）和ALDA量表评估分离性精神病理学及对心境稳定剂治疗的反应。DES评分（均值31.7±21.7）与临床变量、BD特征及病程相关。精神病性症状、混合特征及既往自杀未遂显著预测DES评分[F = 39.880，P < 0.001，校正后R² = 0.713]。分离症状与治疗反应不佳呈负相关（r = -0.593；P < 0.001）。采用横断面设计且样本量小，对精神病性症状进行回顾性临床评估。分离现象与BD尤其是BD-I型中精神病性症状、混合特征及既往自杀未遂密切相关。鉴于分离症状与精神病性症状密切相关，这种关联可能代表BD-I型的一种诊断指标，可指导临床医生规划最恰当的治疗方案。
