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抑郁症门诊患者中未识别出的双相障碍者的临床特征(英文)
引用本文:陈发展,陆峥,郭珍,张旭,杨程青.抑郁症门诊患者中未识别出的双相障碍者的临床特征(英文)[J].上海精神医学,2011,23(2):71-78.
作者姓名:陈发展  陆峥  郭珍  张旭  杨程青
作者单位:1. 同济大学附属同济医院精神医学科,200065
2. 同济大学附属同济医院精神医学科,200065;上海交通大学医学院附属精神卫生中心,200030
摘    要:背景双相障碍常未被识别或被误诊为单相抑郁。明确未被识别或被误诊的双相障碍者的临床特征有助于减少错误分类。目的调查门诊抑郁症患者中未被识别的双相障碍者的比例,并分析未被识别的双相障碍者的临床特征。方法使用32项轻躁狂症状清单(Hypomania Checklist-32,HCL-32)、心境障碍问卷(Mood Disorder Questionnaire,MDQ)和简明国际神经精神访谈(Mini International Neuropsychiatric Interview,MINI)对目前被诊断为抑郁症的100例门诊患者进行调查。对被重新诊断为双相障碍与仍然被诊断为抑郁症的患者的临床特征进行比较分析。结果共有29例(29%)抑郁症门诊患者被诊断为双相障碍;其中双相Ⅰ型6例,双相Ⅱ型23例。与未更改诊断的抑郁症者相比,被重新诊断为双相障碍者年龄轻、起病早、发病次数多、受教育程度高,多为复发性抑郁且多伴精神病性症状。多因素Logistic回归分析显示年龄(OR=0.55,95%CI=0.34~0.89)和精神病性症状(OR=9.12,95%CI=1.56~53.26)是双相障碍的独立危险因素。结论在门诊抑郁症患者中未被识别的双相障碍比例较高,尤其是双相Ⅱ型。与单相抑郁相比,诊断为抑郁症而为未被识别的双相障碍者年龄轻,更可能伴有精神病性症状。

关 键 词:未识别出的双相障碍  抑郁症  门诊患者

Clinical features of unrecognized bipolar disorder in outpatients with major depressive disorder
Fa Zhan CHEN,Zheng LU,Zhen GUO,Xu ZHANG,Cheng QingYANG.Clinical features of unrecognized bipolar disorder in outpatients with major depressive disorder[J].Shanghai Archives of Psychiatry,2011,23(2):71-78.
Authors:Fa Zhan CHEN  Zheng LU  Zhen GUO  Xu ZHANG  Cheng QingYANG
Institution:Fa Zhan CHEN1,Zheng LU1,2,Zhen GUO1,Xu ZHANG1,Cheng Qing YANG11Department of Psychiatry,Tongji Hospital,Tongji University,Shanghai 200065,2Shanghai Mental Health Center,Shanghai Jiao Tong UniversitySchool of Medicine,Shanghai 200030,China
Abstract:Background:Bipolar disorders are often unrecognized or misdiagnosed as unipolar depression.Determining the clinical features associated with unrecognized or misdiagnosed bipolar disorder should help decrease the rates of misclassification.Objective:Estimate the prevalence of unrecognized bipolar disorders among outpatients with major depressive disorder and analyze the clinical characteristics of patients with unrecognized bipolar disorder.Method:100 outpatients with a current diagnosis of major depressive ...
Keywords:Unrecognized bipolar disorder  Major depression disorder  Outpatients  
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