Psychiatric Emergencies Hospital Torcuato de Alvear, Buenos Aires, Argentina.
J Nerv Ment Dis. 2022 Nov 1;210(11):862-868. doi: 10.1097/NMD.0000000000001553. Epub 2022 May 30.
The aim of the current study was to compare the longitudinal clinical course of patients with a history of melancholic and nonmelancholic bipolar depression. Seventy-seven euthymic outpatients with bipolar disorder were categorized as melancholic or nonmelancholic through the clinician-rated Sydney Melancholia Prototype Index. Clinical course was assessed for a period longer than 48 months by time spent ill, density of affective episodes, severity and duration of depressive episodes, and time to depressive recurrence. The mean follow-up time was 69.05 months. Patients with melancholic depressions had more severe and longer depressive episodes during follow-up, whereas patients with nonmelancholic depressions had a shorter time to depressive recurrence and more subsyndromal depressive symptoms and affective instability. These findings highlight the heterogeneity inherent to the current construct of bipolar depression and position melancholia as an interesting target for comparison with nonmelancholic depressions in other external validators in the field of bipolar disorder.
本研究旨在比较既往有单相抑郁和双相抑郁病史的患者的纵向临床病程。通过临床医生评定的悉尼单相抑郁原型指数（Sydney Melancholia Prototype Index），将 77 名单相心境稳定的双相障碍门诊患者分为单相抑郁和双相抑郁。通过患病时间、情感发作频率、抑郁发作严重程度和持续时间以及抑郁复发时间评估病程超过 48 个月。平均随访时间为 69.05 个月。在随访期间，单相抑郁患者的抑郁发作更严重、持续时间更长，而非单相抑郁患者的抑郁复发时间更短，且有更多的亚综合征抑郁症状和情感不稳定。这些发现突显了当前双相抑郁结构固有的异质性，并将单相抑郁定位为双相障碍领域其他外部验证器中与非单相抑郁进行比较的一个有趣靶点。
