Winokur G, Coryell W, Akiskal H S, Endicott J, Keller M, Mueller T
US National Institute of Mental Health, Collaborative Program on Psychobiology of Depression, Bethesda, Maryland.
Acta Psychiatr Scand. 1994 Feb;89(2):102-10. doi: 10.1111/j.1600-0447.1994.tb01495.x.
For a five-year period, 131 bipolar patients were followed every 6 months; for the next 5 years, they were followed yearly. Each patient was interviewed in a systematic way that gave information about episodes, hospitalizations, cycle lengths and the presence of alcoholism. Women and men were not significantly different in the number of follow-up manic or depressive episodes or hospitalizations. Chronicity from index episode to the end of the 10-year follow-up was uncommon (4%). Alcoholism, which was common in these patients, showed a great diminution at the end of 10 years. Contrary to expectation, cycle lengths showed no systematic decrease in length over the follow-up. In this naturalistic study, treatment intensity was not related to decreasing episodes or to changes in cycle length. The number of episodes in the first 5 years of follow-up was not correlated with the number of episodes in the last 5 years. Cycle lengths in the first 5 years of follow-up were similar in length to the last 5 years of follow-up. A family history of mania in these bipolar patients was associated with more episodes in follow-up than if such a family history were absent. The patients whose alcoholism predated the onset of their affective illness were less likely to have episodes in the follow-up than the patients in whom affective illness predated the onset of the alcoholism.
在五年的时间里，对131名双相情感障碍患者每6个月进行一次随访；在接下来的5年里，每年进行一次随访。对每位患者进行系统访谈，以获取有关发作、住院情况、发作周期长度以及是否存在酒精中毒的信息。女性和男性在随访期间躁狂或抑郁发作的次数或住院次数上没有显著差异。从首次发作到10年随访结束的慢性病程并不常见（4%）。这些患者中常见的酒精中毒在10年末有了显著减少。与预期相反，在随访期间发作周期长度没有系统性缩短。在这项自然主义研究中，治疗强度与发作次数减少或发作周期长度变化无关。随访前5年的发作次数与后5年的发作次数无关。随访前5年的发作周期长度与后5年相似。这些双相情感障碍患者中有躁狂家族史的在随访中的发作次数比没有这种家族史的患者更多。酒精中毒早于情感疾病发作的患者在随访中发作的可能性低于情感疾病早于酒精中毒发作的患者。
