Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain.
Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona. c. Villarroel, 170, 08036 Barcelona, Spain.
Psychol Med. 2024 Jul;54(10):2344-2346. doi: 10.1017/S0033291724001016. Epub 2024 May 10.
The controversy on whether bipolar disorder is a neurodevelopmental versus a neuroprogressive illness is still around, despite some reductionistic claims that only one model is right. The current diagnostic classifications are not helpful to address this issue, and there is conflicting evidence in favor and against either model. In practice, though, understanding that many patients may show a progressive cognitive and functional decline which may be correlated with the number and severity of episodes may lead to better outcomes through early intervention strategies.
尽管有人主张只有一种模式是正确的,从而使双相障碍是神经发育性疾病还是神经退行性疾病的争议有所减少,但该争议仍然存在。目前的诊断分类无助于解决这个问题,而且支持或反对任何一种模式的证据都存在矛盾。不过,在实践中,了解到许多患者可能表现出进行性认知和功能下降,这种下降可能与发作的次数和严重程度相关,这可能通过早期干预策略来改善预后。