Shulman K, Post F
Br J Psychiatry. 1980 Jan;136:26-32. doi: 10.1192/bjp.136.1.26.
In a retrospective study of 67 elderly bipolar patients the first manic attack occurred at about age 60, often after a long period from the time of the first affective episode, after which further depressive episodes occurred. This calls into question Perris' criteria for unipolar diagnosis. Among the men, a preponderance of cerebral-organic disorders was found. The evidence for sub-classification of bipolar disorders into secondary or symptomatic manias is discussed. The recurrent nature of the illness in old age stresses the need for further evaluation of lithium prophylaxis.
在一项对67例老年双相情感障碍患者的回顾性研究中，首次躁狂发作约发生在60岁左右，通常是在首次情感发作后的很长一段时间之后，此后还会出现进一步的抑郁发作。这对佩里斯的单相诊断标准提出了质疑。在男性患者中，发现脑器质性疾病占多数。文中讨论了将双相情感障碍分为继发性或症状性躁狂的证据。老年期疾病的复发性质强调了对锂盐预防性治疗进行进一步评估的必要性。
