Hays J C, Krishnan K R, George L K, Blazer D G
Department of Psychiatry, Duke University, Durham, North Carolina 27710, USA.
Depress Anxiety. 1998;7(2):76-82.
The literature suggests that bipolar elders with early and late onset of the disorder present with different demographic, family history, and psychosocial profiles, which are less well characterized than those for elderly unipolar patients. In this cross-sectional clinical survey, we assessed subjects (n = 74) from the NIMH Clinical Research Center for the Study of Depression in Later Life at Duke University who had a consensus diagnosis of bipolar depression; the primary assessment instrument was the Duke Depression Evaluation Schedule. We found that bipolar subjects with later age of onset reported less family history of psychiatric problems, more comorbid vascular disease, and more instrumental and subjective social support. Stressful life events were more frequent among bipolar subjects with earlier age of depressive symptom onset. This study suggests that early-onset disorder may be characterized by a psychosocial component, whereas organic factors may be particularly important to late-onset bipolar disorder.
文献表明，早发型和晚发型双相情感障碍的老年患者在人口统计学、家族史和心理社会特征方面存在差异，与老年单相抑郁患者相比，这些特征的描述尚不充分。在这项横断面临床调查中，我们评估了来自杜克大学国家心理健康研究所（NIMH）晚年抑郁症临床研究中心的74名受试者，他们均被一致诊断为双相抑郁；主要评估工具是杜克抑郁评估量表。我们发现，晚发型双相情感障碍受试者报告的精神疾病家族史较少、合并血管疾病较多，以及获得的工具性和主观性社会支持较多。抑郁症状早发的双相情感障碍受试者中，生活应激事件更为频繁。这项研究表明，早发型双相情感障碍可能以心理社会因素为特征，而器质性因素可能对晚发型双相情感障碍尤为重要。
