中国七个地区情感性精神障碍流行病学调查

目的了解９０年代情感性精神障碍患病率及与１９８２年比较的变动情况。方法于１９９３年在７个原抽样地区，使用与１９８２年基本相同的调查工具、诊断标准及流程，进行流行病学调查。结果在≥１５岁１９２２３人口中，查出情感性精神障碍１６例，其中６例处于缓解期。时点患病率为０．５２‰，终生患病率为０．８３‰。与１９８２年相同７个地区比较，城市患病率呈上升趋势。结论情感性精神障碍应列入防治与研究的重点疾病。     

中国七个地区精神疾病流行病学调查

目的了解９０年代各类精神障碍患病率及与１９８２年比较的变动情况。方法由１９８２年调查协作组中的７个单位，于１９９３年在７个原抽样地区进行流行病学调查，方法与１９８２年基本相同。结果各类精神障碍（不含神经症）时点患病率１１．１８‰，终生患病率１３．４７‰；与１９８２年比较，均有所上升。结论精神分裂症和精神发育迟滞患病率仍居前两位，而酒依赖、情感性精神障碍、阿尔茨海默病和脑血管病所致精神障碍患病率升高，均应列为防治和研究的重点     

阜阳市情感障碍的流行病学调查

目的了解阜阳市城乡情感性精神障碍患病状况及相关因素，初步探讨我国情感性精神障碍患病率较低的原因。方法2000年儿月～2001年3月在阜阳市区和3县农村进行精神疾病流行病学调查，共调查≥15岁者33332人，以心理卫生筛选表进行筛查，阳性者作精神现状检查及社会功能缺陷量表检查．以中国精神疾病分类方案与诊断标准第2版修订本进行诊断。结果共查出情感性精神障碍患者39例．现患26例。终生患病率为1．17‰，时点患病率为0，78‰.青壮年患病率较高．并有明显的遗传倾向，农村和低收入家庭患病率相对较低．但未识别率和未治疗率却较高。结论我国的患病率低可能与情感性精神障碍分类的范围及人们对本病的认识水平有关。建议卫生部门将情感性精神障碍列为以后重点防治的疾病范围。     

1993年中国七个地区精神分裂症流行病学调查资料的气候因素再分析

对 1 993年中国 7个地区精神分裂症流行病学调查资料进行分析 ,以了解一个地区的气候因素与该地区精神分裂症患病率的关系。资料　选自 1 993年中国 7个地区精神分裂症流行病学调查资料 ,调查人数及精神分裂症患病率见文献 [1 ]。 (1 )气候学资料 :按 7个地区在《中华人民共和国地图集》[2 ] 中所处的位置 ,分别标入“中国年平均气温图”、“中国年日照时数图”及“中国年降水量图”。取各图中所代表颜色柱的上限和下限的平均值 ,作为年平均气温、年平均日照时数和年平均降水量。在 7个地区所处省 (市 )的地图中 ,用刻度尺进行等比例划分 ,…     

首发情感性精神障碍发病季节圆形统计分析

目的：探讨情感性精神障碍发病与季节的关系。方法：对321例情感性精神障碍患者作发病高峰时间的圆形统计分析。结果：男性以躁狂起病者的发病高峰时间差异具有显著性，发病高峰时间约为6月10日，女性以躁狂起病者以夏季为发病高峰期。以抑郁起病者不论男、女均多以秋、冬季节较为集中。结论：情感性精神障碍发病与季节有一定关系。     

九江市精神疾病及其残疾流行病学调查

目的：了解九江市各类精神障碍患病率及精神残疾和智力残疾状况。方法：采用中国精神障碍分类与诊断标准第3版、精神残疾与智力残疾评定工具，对九江市11个抽样地区进行流行病学调查。结果：共调查市辖区55户，市辖县550户，共调查2636人。在≥15岁人口中，各类精神障碍的时点患病率为24．33‰，终生患病率为27．80‰，精神残疾率为8．94‰，智力残疾率为4．97‰。在≥7岁人口中，精神发育迟滞的时点患病率为3．31‰。在调查的总人口中，精神残疾率为6．83‰，智力残疾率为3．79‰。结论：心境障碍患病率居首位，精神分裂症和精神发育迟滞居2、3位，酒依赖患病率升高，均应列为防治和研究重点。     

广东中山市精神疾病流行病学调查

目的 了解中山市精神疾病流行病学情况。方法 采用WHO提供,1982年和1993年两次全国精神疾病流行病学调查使用的方法,对中山市城乡3721人行社会人口学调查及15岁以上人口精神疾病患病情况调查。结果 中山市精神疾病(不含神经症和海洛因依赖)时点患病率26.13‰,终生患病率为29.91‰;两者明显高于1993年中国七地区精神疾病流行病学调查结果(相应为11.18‰和13.74‰,P均小于0.01)。神经症(均为现患病例)的时点患病率为29.70‰,海洛因依赖终生患病率为7.56‰。结论 中山市精神分裂症和精神发育迟滞仍居前两位,而酒依赖、情感性精神障碍、脑器质性眠精神障碍及镇静眠药物依赖患病率升高,神经症、海洛因依赖患病率居国内较高水平,应列为防治和研究的重点。     

情感性精神障碍与气象要素

目的探讨情感性精神障碍与气象要素的关系。方法对天津市安定医院1997-1999年情感性精神障碍月入院量和同期气象资料的相关性进行回顾性分析。结果情感性精神障碍月入院量与同期气压、日照有显著意义的相关。结论日照、气压和风速可能是情感性精神障碍发病的主要气象影响因素。     

性格与情感性精神障碍结局的关系

目的：探讨性格与情感性精神障碍结局的关系。方法：对１１７例情感性精神障碍患者进行出院８年的随访调查，并将其分为性格内倾组、外倾组，采用社会功能缺陷筛选量表（ＳＤＳＳ）进行评定。结果：两组复发、再住院、自杀、慢性化、死亡率均无显著差异，出现社会功能缺陷者性格内倾组明显高于性格外倾组，主要表现在职业和工作、婚姻职能、社会性退缩３方面，而性格外倾组病后对外界的兴趣和关心受损较显著。结论：病前性格内倾者社会功能缺陷高于性格外倾者。     

抑郁症的多形性表现

双相情感性精神障碍的终生患病率较单相抑郁为低，约为０．４％～１．１％；单相抑郁或称重性抑郁的终生患病率为５．２％～１６．２％［１］。就抑郁的严重程度而言，重度与轻度之比为１∶５［２］。重度患者多受到精神病医院的关注，而数量众多的轻性抑郁多就诊于初级保...     

精神分裂症和情感障碍混合家系的遗传调查

目的 探讨精神分裂症和情感障碍混合家系的遗传效应。方法 采用严格的纳入标准,应用家族史法对55例混合家系的各级亲属2134人进行详细的调查记录。分三组进行分析。结果 (1)精神分裂症为先证者组,各级亲属精神分裂症的患病率为1.1％,与1993年全国七地区调查精神分裂症的群体患病率0.655％比较,P>0.05,统计学上无显著差异,一级亲属患病率为4.79％,各群体比较,P<0.05。各级亲属情感障碍的患病率为3.78％,与1992年全国七地区调查情感障碍的群体患病0.083％比较,P<0.05,统计学上有显著差异,一级亲属患病率为17.96％。(2)情感障碍为先证者组,各级亲属情感障碍患者率为1.234％,与群体比较,P<0.05,一级亲属患病为4.76％。各级亲属精神分裂症的患病率为3.67％,与群体比较,P<0.05,一级亲属患病率为12.24％。(3)混合组,各级亲属精神分裂症的患病率为2.27％,与群体比较,P<0.05,一级亲属患病率为9.44％。结论 混合家系中,血缘关系越近,亲属中精神分裂症和情感障碍的患病率越高;精神分裂症和情感障碍在遗传传递上可能具有交叉性。     

Seasonality in affective disorders in Switzerland

OBJECTIVE: To estimate the prevalence of seasonal affective disorder (SAD) and its subsyndromal form (S-SAD) in Switzerland (47 degrees N). METHOD: A representative sample from all three language areas of Switzerland (n = 980) were given a structured telephone interview using the extended Seasonal Pattern Assessment Questionnaire (SPAQ+). A smaller, but also representative sample in the city of Basel filled in the SPAQ+ form as well as undergoing a structured diagnostic interview. RESULTS: In this Swiss sample, 2.2% of the population presented with symptom severity of SAD, 8.9% with S-SAD. In Basel, a much higher prevalence of SAD was found. Seasonal problems occurred more often in patients with the Diagnostic and Statistical Manual (DSM)-III diagnosis of major affective disorders than in those with pure anxiety disorders or no psychiatric diagnosis. CONCLUSION: These estimates for SAD in Switzerland are similar to those found in the Zürich Study, using other methods, and for populations in the UK, with the limitations inherent in retrospective questionnaire studies.     

情感性精神障碍患者的入院态度分析

目的：探讨情感性精神障碍患者的入院态度及其影响因素。方法：对81抑郁症患者和64例躁狂症患者的入院态度及其影响因素进行评估，并对影响因素作Logistic回归分析。结果：抑郁症患者的自愿入院率为32．1％，非自愿入院率为53．1％，强迫入院率为14．8％。躁狂症患者分别为10.9％、51.6％和37.5％。多因素Logistic回归分析显示，抑郁症患者的住院次数、自知力、治疗时间及Hamilton抑郁量表(HAMD)总分进入了回归方程；躁狂症患者的自知力、Bech Rafaelsen躁狂量表(BRMS)总分及自我评价项目进入回归方程。结论：情感性精神障碍患者人院态度受多种因素影响。     

Relative humidity and affective disorders

INTRODUCTION: Looking at specific weather parameters over a period of time prior to hospital admissions may provide evidence of a link between weather conditions and some psychiatric conditions such as affective disorders. We examined the association between relative humidity (as well as other parameters such as sunshine hours, diurnal variations in temperature and rainfall) and psychiatric admissions in North Cheshire, UK. METHOD: The daily numbers of all psychiatric admissions in North Cheshire in a specified year were analysed in relation to meteorological data, which were measured at the meteorological office nearest to the study population. RESULTS: We found a significant inverse relationship (with time lag) between admissions for affective disorders and relative humidity in the week preceding admission. Changes in diurnal variations in temperature, sunshine hours and rainfall a few days before admission were also noted, but the findings did not achieve statistical significance for any diagnostic category. CONCLUSION: The effect of weather parameters on mental health is likely to be influenced by other seasonal factors, as well as non-climatic factors, predominantly social, that may have contributed to the study findings. Psychiatric admissions reflect the behaviour of patients, carers and medical professionals. The complexity of this behaviour and the day-of-the-week periodicity may have confounded variations associated with the weather. (Int J Psych Clin Pract 2002; 6: 147-153 )     

White matter hyperintensities and their associations with suicidality in patients with major affective disorders

INTRODUCTION: A large body of evidence suggests that predisposition to suicide, an important public health problem, is mediated to a certain extent by neurobiological factors. The objective of this cross-sectional study was to compare the prevalence of white matter hyperintensities (WMH) in patients with major affective disorders with and without histories of suicide attempts. METHODS: T2-weighted magnetic resonance images (MRI) of 65 psychiatric inpatients with major depressive disorder or bipolar disorder were rated for the presence of WMH. Diagnoses, presence or absence of suicide risk and substance abuse were determined by the Mini International Neuropsychiatric Interview (MINI). Medical charts were reviewed to ascertain history of suicide attempt and basic clinical variables. Fisher's Exact Tests and logistic regression modeling were used to test the association between WMH and suicidality. Suicidal patients and controls were not matched for demographic variables and exposure to some risk factors. RESULTS: Bivariate analysis showed that the prevalence of WMH was significantly higher in subjects with past suicide attempts (Fisher's Exact Test, p = 0.01) and other clinical indicators of elevated suicide risk. Logistic regression analyses controlling for age, sex, and several clinical risk factors supported this finding (odds ratio = 4.7; 95% confidence interval: 1.4, 16.1). CONCLUSIONS: The increased prevalence of WMH in adults with major affective disorders and a history of suicide attempt, compared to similar patients without such a history, is consistent with previous findings in depressed children, youth and young adults. However, the association between WMH and suicidality holds true for both, depressed and bipolar patients. Our results suggest that WMH in patients with major affective disorders might be useful biological markers of suicidality.     

Modelling suicide risk in affective disorders.

BACKGROUND: The lifetime risk of suicide in affective disorders is commonly quoted as 15%. This stems from hospital populations of affective disorders. AIMS: To model the lifetime prevalence of suicide using data on completed suicides from one English Health District and community-based rates of prevalence of affective disorders. METHODS: A secondary analysis of a primary data set based on 212 suicides in North Staffordshire was undertaken. The population rates of psychiatric morbidity were obtained from the National Comorbidity Survey. RESULTS: The model suggests a lifetime prevalence rate of suicide for any affective disorder at 2.4%, with a rate for those uncomplicated by substance abuse, personality disorder or non-affective psychosis at 2.4%, and a rate for uncomplicated cases who had no mental health service contact at 1.1%. CONCLUSIONS: Lifetime prevalence rates of suicide in subgroups of affective disorders may be lower than the traditional rates cited for hospital depression. This has implications for primary care projects designed to investigate the occurrence of and the prevention of suicide.     

Comorbidity of eating disorders and bipolar affective disorders

Eating disorders--anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) occur usually in young females. The significant pathogenic differences between patients who only restrict food, and patients with binge eating and compensatory behaviours, such as vomiting and purging were described. The prevalence of bipolar affective disorders--especially bipolar II and bipolar spectrum disorders (BS) may reach 5% in the general population. About half of the depressive episodes are associated with a "mild" bipolar disorder, and such a diagnosis is suggested by impulsivity and mood-instability. Previously, majority of research on the comorbidity between eating and affective disorders focused on depressive symptomatology, however difficulties in the reliable assessment of hypomania may obfuscate the estimation of the co-occurrence of eating disorders with BS. Epidemiological studies suggest the association between BS and eating disorders with binge episodes (bulimia nervosa, anorexia- bulimic type and EDNOS with binge episodes). Co-occurrence of such disorders with depressive symptoms probably suggests the diagnosis of BS, not recurrent depression. Bulimic behaviours, impulsivity and affective disorders might be related to the impairment of the serotonergic neurotransmission, which may result from the genetic vulnerability and early life trauma. Currently, the first-line pharmacological treatment of co-occurring eating disorders with binge episodes and BS are selective serotonin reuptake inhibitors. However in some cases, the use of mood-stabilising agents as monotherapy or in combination with serotonergic drugs may be helpful.     

Individual and familial risk factors for bipolar affective disorders in Denmark

BACKGROUND: Few population-based studies have addressed risk factors for bipolar affective disorder. OBJECTIVE: To study the possible association between bipolar affective disorder and history of mental illness in a parent or sibling; urbanicity of birth place; season of birth; sibship characteristics, including birth order; influenza epidemics during pregnancy; and early parental loss. DESIGN: We used a population-based cohort of 2.1 million individuals based on data from the Danish Civil Registration System linked with the Danish Psychiatric Central Register. SETTING: Nationwide population-based sample of all individuals hospitalized or in outpatient clinic contact for the first time with bipolar affective disorder.Patients Overall, 2299 individuals were first diagnosed with bipolar affective disorder during the 31.8 million person-years of follow-up. RESULTS: Risk of bipolar affective disorder was associated with a history of bipolar affective disorder as well as other psychiatric disorders, including schizophrenia and schizoaffective disorder, in parents or siblings. People with a first-degree relative with bipolar affective disorder had a 13.63-fold (95% confidence interval, 11.81-15.71) increased risk of bipolar affective disorder. No other consistent associations were found with the exception of an association between early parental loss, in particular maternal, and bipolar affective disorder. Children who experienced maternal loss before their fifth birthday had a 4.05 (95% confidence interval, 1.68-9.77) increased risk of bipolar affective disorder. CONCLUSIONS: Early parental loss may represent both environmental and genetic risk factors for bipolar affective disorder. Most of the risk factors included in our study that previously have been associated with schizophrenia were not associated with bipolar affective disorder, supporting that the 2 disorders may be at least partially separate etiological entities.     

Genetic models of the transmission of affective disorders

Multiple threshold models of inheritance of liability to semi-continuous traits are applied to data on affective and related disorders in relatives of 70 patients with bipolar or unipolar affective disorder, relatives of 75 normal controls, and population prevalence data. Unipolar and bipolar affective disorders and related affective disturbances are represented in the model at different thresholds on a single continuum of genetic-environmental liability. Neither a multifactorial inheritance or single major locus inheritance can be ruled out as a mode of transmission. The heritability of affective disorders appears to be greater than 0·.