Kong Shuqi, Niu Zhiang, Lyu Dongbin, Cui Lvchun, Wu Xiaohui, Yang Lu, Qiu Hong, Gu Wenjie, Fang Yiru
Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Information and Statistical Department, Shanghai Mental Health Center, Shanghai, China.
Front Psychiatry. 2022 Apr 6;13:847485. doi: 10.3389/fpsyt.2022.847485. eCollection 2022.
This study was to investigate the characteristics of seasonal symptoms and non-enzymatic oxidative stress in the first hospitalized patients with bipolar and unipolar depression, aiming to differentiate bipolar depression from unipolar depression and reduce their misdiagnosis. A total of 450 patients with bipolar depression and 855 patients with depression were included in the present study. According to the season when the patients were admitted to the hospital due to the acute onset of depression, they were further divided into spring, summer, autumn and winter groups. According to the characteristics of symptoms of bipolar disorder in the DSM-5, the characteristic symptoms of bipolar disorder were collected from the medical record information, and clinical biochemical indicators that can reflect the oxidative stress were also recorded. The seasonal risk factors in patients with bipolar or unipolar depression were analyzed. The relationship of age and gender with the bipolar or unipolar depression which attacked in winter was explored. There were significant differences between groups in the melancholic features, atypical features and conjugated bilirubin in spring. In summer, there were significant differences between groups in the melancholic features, uric acid and conjugated bilirubin. In autumn, there were marked differences between groups in melancholic features, anxiety and pain, atypical features, uric acid, total bilirubin, conjugated bilirubin and albumin. In winter, the conjugated bilirubin and prealbumin were significantly different between two groups. The melancholic features and uric acid that in summer as well as melancholic features, uric acid and total bilirubin in autumn were the seasonal independent risk factors for the unipolar depression as compared to bipolar depression. In winter, significant difference was noted in the age between two groups. In conclusion, compared with patients with unipolar depression, patients with bipolar depression have seasonal characteristics. Clinical symptoms and indicators of oxidative stress may become factors for the differentiation of seasonal unipolar depression from bipolar depression. Young subjects aged 15-35 years are more likely to develop bipolar depression in winter.
本研究旨在调查首次住院的双相抑郁和单相抑郁患者的季节性症状及非酶促氧化应激特征，以鉴别双相抑郁和单相抑郁并减少误诊。本研究共纳入450例双相抑郁患者和855例抑郁患者。根据患者因抑郁急性发作入院时的季节，将其进一步分为春、夏、秋、冬组。根据《精神疾病诊断与统计手册》第5版中双相情感障碍的症状特征，从病历信息中收集双相情感障碍的特征性症状，并记录可反映氧化应激的临床生化指标。分析双相或单相抑郁患者的季节性危险因素。探讨年龄和性别与冬季发作的双相或单相抑郁的关系。春季，各组在抑郁特征、非典型特征和结合胆红素方面存在显著差异。夏季，各组在抑郁特征、尿酸和结合胆红素方面存在显著差异。秋季，各组在抑郁特征、焦虑和疼痛、非典型特征、尿酸、总胆红素、结合胆红素和白蛋白方面存在明显差异。冬季，两组的结合胆红素和前白蛋白有显著差异。与双相抑郁相比，夏季的抑郁特征和尿酸以及秋季的抑郁特征、尿酸和总胆红素是单相抑郁的季节性独立危险因素。冬季，两组年龄存在显著差异。总之，与单相抑郁患者相比，双相抑郁患者具有季节性特征。氧化应激的临床症状和指标可能成为季节性单相抑郁与双相抑郁鉴别的因素。15至35岁的年轻受试者在冬季更易患双相抑郁。
