The enduring psychosocial consequences of mania and depression.
The enduring psychosocial consequences of mania and depression.
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躁狂症和抑郁症的持久心理社会后果。
DOI：
10.1176/ajp.150.5.720
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Klerman,GL
中科院分区：
文献类型：
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作者：
Coryell,W;Scheftner,W;Keller,M;Endicott,J;Maser,J;Klerman,GL
目的：作者试图确定双相和单相情感障碍引起的心理社会损害的范围、严重程度和持久性。方法对双相情感障碍（N= 148）或单相情感障碍（N= 240）患者在寻求治疗时进行评估，并在5年随访后再次进行评估。同时，对父母、兄弟姐妹和成年子女进行了类似的评估，并进行了6年的随访。为了量化情感障碍的影响，先证者分别与没有情感障碍终生病史的亲属相匹配。69名在接受治疗时患有抑郁症的亲属组成了一个独立的非临床研究小组，并与健康的亲属相匹配。结果单极和双相患者均以年收入不足开始随访。与比较对象相比，情感障碍组在随访结束时更有可能报告工作地位和收入下降，而报告改善的可能性更小。同样，在随访中，双相情感障碍和单相情感障碍患者在几乎所有其他社会心理功能方面都表现出明显的缺陷。除了与配偶的关系外，缺陷在极性上没有显著差异。令人惊讶的是，在最后2年的随访中，恢复的先证者也表现出严重和广泛的损伤。重度抑郁症亲属在随访中表现出明显的缺陷，但对其工作状态和收入没有显著影响。结论与狂躁和重度抑郁症相关的心理社会障碍基本上延伸到所有功能领域，并持续数年，甚至在临床症状持续消退的个体中也是如此。
ObjectiveThe authors sought to determine the scope, severity, and persistence of psychosocial impairment arising from bipolar and unipolar affective disorder.MethodPatients with bipolar (N= 148) or unipolar (N= 240) major affective disorder were assessed as they sought treatment and again after a 5-year follow-up. Concurrently, parents, siblings, and adult children underwent similar assessments and were followed for 6 years. To quantify the impact of affective disorder, probands were individually matched to relatives who had no lifetime history of affective disorder. Sixty-nine relatives who were depressed at intake constituted a separate, nonclinical study group and were also matched to relatives who were well.ResultsBoth unipolar and bipolar patients began follow-up with deficits in annual income. Relative to comparison subjects, affective disorder groups were significantly more likely to report declines in job status and income at the end of follow-up and significantly less likely to report improvements. Similarly, both bipolar and unipolar patients showed significant deficits in nearly all other areas of psychosocial functioning measured at follow-up. Except for relationships with spouses, deficits did not differ significantly by polarity. Surprisingly, probands with recovery sustained throughout the final 2 years of follow-up also showed severe and widespread impairment. Relatives with major depression exhibited substantial deficits on follow-up, but job status and income were not significantly affected.ConclusionsThe psychosocial impairment associated with mania and major depression extends to essentially all areas of functioning and persists for years, even among individuals who experience sustained resolution of clinical symptoms.