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季节性和非季节性心境障碍中的抑郁症状及家族史。

Depressive symptoms and family history in seasonal and nonseasonal mood disorders.

作者信息

Allen J M, Lam R W, Remick R A, Sadovnick A D

机构信息

Department of Psychiatry, University of British Columbia, Vancouver, Canada.

出版信息

Am J Psychiatry. 1993 Mar;150(3):443-8. doi: 10.1176/ajp.150.3.443.

Abstract

OBJECTIVE

The authors' goal was to compare the symptoms and family history of seasonal affective disorder with those of nonseasonal mood disorders.

METHOD

From a subspecialty mood disorders clinic, 34 patients with major depression, seasonal pattern (seasonal affective disorder), diagnosed with DSM-III-R criteria, were matched in age, sex, and diagnostic subtype (recurrent unipolar, bipolar I, or bipolar II) to 34 patients with nonseasonal mood disorders. Data on symptoms during the most recent depressive episode were obtained by chart review and compared by using chi-square tests. Family history data for first-degree relatives of patients with seasonal and nonseasonal mood disorders were gathered by using the family history method, and diagnoses were based on Family History Research Diagnostic Criteria.

RESULTS

Patients with seasonal affective disorder reported significantly more hypersomnia, hyperphagia, and weight gain and reported less suicidal ideation and morning worsening of mood than the patients with nonseasonal mood disorders. No differences were found in family histories of mood disorders, other psychiatric disorders, and any psychiatric disorder between the groups with seasonal versus nonseasonal mood disorders. Alcoholism was found more frequently in the relatives of the patients with seasonal affective disorder.

CONCLUSIONS

Differences in symptoms between seasonal and nonseasonal mood disorders provide some support for seasonal affective disorder as a diagnostic subtype of mood disorders. However, the genetic loading for mood disorders (of unspecified seasonality), as determined by the family history method, is similar for seasonal and nonseasonal mood disorders.

摘要

目的

作者的目标是比较季节性情感障碍与非季节性心境障碍的症状及家族史。

方法

从一家亚专科心境障碍诊所中,选取34例符合DSM-III-R标准、诊断为重度抑郁发作(季节性模式,即季节性情感障碍)的患者,按照年龄、性别和诊断亚型(复发性单相、双相I型或双相II型)与34例非季节性心境障碍患者进行匹配。通过查阅病历获取最近一次抑郁发作期间的症状数据,并使用卡方检验进行比较。采用家族史方法收集季节性和非季节性心境障碍患者一级亲属的家族史数据,诊断依据家族史研究诊断标准。

结果

与非季节性心境障碍患者相比,季节性情感障碍患者报告的嗜睡、贪食和体重增加更为显著,而自杀观念和晨起时情绪恶化则较少。季节性与非季节性心境障碍组之间在心境障碍、其他精神障碍以及任何精神障碍的家族史方面未发现差异。在季节性情感障碍患者的亲属中,酗酒更为常见。

结论

季节性和非季节性心境障碍在症状上的差异为季节性情感障碍作为心境障碍的一种诊断亚型提供了一定支持。然而,通过家族史方法确定的(未明确季节性的)心境障碍的遗传负荷,在季节性和非季节性心境障碍中相似。

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