Lish J D, Gyulai L, Resnick S M, Kirtland A, Amsterdam J D, Whybrow P C, Price R A
Dept. of Psychiatry, University of Pennsylvania, Philadelphia 19104-2648.
Psychiatry Res. 1993 Jul;48(1):37-46. doi: 10.1016/0165-1781(93)90111-s.
Previous studies have yielded mixed evidence as to whether rapid-cycling bipolar disorder (four or more episodes per year) is associated with a distinctive pattern of patient characteristics and familial aggregation of affective disorder. In this study, Family History Research Diagnostic Criteria (FH-RDC) were used to interview 165 patients with rapid-cycling bipolar disorder, non-rapid-cycling bipolar disorder, or recurrent unipolar depressive disorder about the psychiatric history of 812 adult first-degree relatives. In a validity study, FH-RDC diagnoses were demonstrated to agree reasonably well with best-estimate diagnoses by two psychiatrists/psychologists, based on direct interviews with the Structured Clinical Interview for DSM-III-R. Relatives of patients with recurrent unipolar depression were less likely to have bipolar disorder and more likely to have unipolar depression than were relatives of rapid-cycling or non-rapid-cycling bipolar patients. Rapid-cycling patients were younger and more likely to be female than non-rapid-cycling patients. The relatives of rapid cyclers did not differ significantly from those of non-rapid cyclers in the prevalence of bipolar disorder, unipolar disorder, rapid-cycling bipolar disorder, or substance abuse. However, there were nonsignificant trends for the relatives of rapid-cycling bipolar patients, compared with those of non-rapid-cycling bipolar patients, to have more substance abuse and less bipolar disorder given the presence of affective disorder.
先前的研究对于快速循环型双相情感障碍（每年发作四次或更多次）是否与独特的患者特征模式及情感障碍的家族聚集性相关，得出了混杂的证据。在本研究中，采用家族史研究诊断标准（FH-RDC）对165例患有快速循环型双相情感障碍、非快速循环型双相情感障碍或复发性单相抑郁症的患者进行访谈，了解其812名成年一级亲属的精神病史。在一项效度研究中，基于对《精神疾病诊断与统计手册第三版修订本》（DSM-III-R）结构化临床访谈的直接访谈，FH-RDC诊断结果被证明与两位精神科医生/心理学家的最佳估计诊断结果相当吻合。与快速循环型或非快速循环型双相情感障碍患者的亲属相比，复发性单相抑郁症患者的亲属患双相情感障碍的可能性较小，患单相抑郁症的可能性较大。快速循环型患者比非快速循环型患者更年轻，且女性比例更高。快速循环型患者的亲属在双相情感障碍、单相情感障碍、快速循环型双相情感障碍或物质滥用的患病率方面与非快速循环型患者的亲属没有显著差异。然而，与非快速循环型双相情感障碍患者的亲属相比，快速循环型双相情感障碍患者的亲属在患有情感障碍时，存在物质滥用较多且双相情感障碍较少的非显著趋势。
