Shulman K I, Tohen M
Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
Br J Psychiatry. 1994 Apr;164(4):547-9. doi: 10.1192/bjp.164.4.547.
Earlier studies have failed to differentiate the unipolar manic subtype from bipolar patients with both manic and depressive episodes. This retrospective cohort study of 50 elderly manic in-patients identified six patients (12%) who met strict criteria for a course of unipolar mania. Significant differences emerged in age at onset, with a mean of 41.2 years for unipolar mania compared with 64.7 years for the others. Consequently, clinical course was significantly longer, 27.7 v. 7.4 years. Elderly patients pursuing a unipolar manic course are among the very few elderly 'bipolars' whose illness begins early in life. Recent neuroradiological investigations and data from geriatric studies suggest that the concept of unipolar mania is worthy of further investigation.
早期研究未能将单相躁狂亚型与既有躁狂发作又有抑郁发作的双相情感障碍患者区分开来。这项对50名老年躁狂住院患者的回顾性队列研究确定了6名患者（12%）符合单相躁狂病程的严格标准。发病年龄出现了显著差异，单相躁狂的平均发病年龄为41.2岁，而其他患者为64.7岁。因此，临床病程明显更长，分别为27.7年和7.4年。患有单相躁狂病程的老年患者是极少数发病于早年的老年“双相情感障碍患者”。最近的神经放射学研究和老年医学研究数据表明，单相躁狂的概念值得进一步研究。
