Functional impairment in bipolar II disorder: is it as disabling as bipolar I?
Functional impairment in bipolar II disorder: is it as disabling as bipolar I?
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DOI：
10.1016/j.jad.2010.05.014
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发表时间：
2010-12
影响因子：
6.6
通讯作者：
A. Rosa;C. Bonnín;Gustavo H. Vázquez;M. Reinares;B. Solé;R. Tabarés-Seisdedos;V. Balanzá-Martínez;Ana González-Pinto;J. Sánchez-Moreno;E. Vieta
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文献类型：
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作者：
A. Rosa;C. Bonnín;Gustavo H. Vázquez;M. Reinares;B. Solé;R. Tabarés-Seisdedos;V. Balanzá-Martínez;Ana González-Pinto;J. Sánchez-Moreno;E. Vieta
已经证实，双相情感障碍患者即使在缓解期也会经历功能损害。然而，双相情感障碍II型仍未得到充分的研究，因为迄今为止大多数调查仅包括双相情感障碍I型患者或双相情感障碍II型患者的一小部分样本，没有明确比较两种亚型的障碍。本报告的主要目的是评估整体和多个功能领域，特别是双相情感障碍II患者与双相情感障碍I患者和健康受试者的比较。方法对3组233名受试者进行比较：双相情感障碍I型患者（n=106）、双相情感障碍II型患者（n=66）和健康对照组（n=61）。在巴塞罗那医院诊所和阿根廷不同的研究地点招募了符合缓解标准的双相患者。采用17项汉密尔顿抑郁评定量表（HAM-D）、青年躁狂症评定量表（YMRS）和功能评定短测试（FAST）进行评定。临床和社会人口统计数据也被记录下来。结果与健康对照组相比，双相I和双相II两个亚组患者的总体功能（p<0.001）和FAST量表的每个领域（均p<0.001）均较低。Tukey事后测试显示，双相情感障碍II型患者在认知领域的得分比双相情感障碍I型患者更差。然而，在控制了潜在的混杂变量后，这种差异消失了，只有年龄较大（p<0.005）和HAM-D评分（p<0.001）仍然显著。结论双相情感障碍II型患者的残疾程度与双相情感障碍I型患者相同。这在一定程度上可以解释，因为II型双相患者比I型双相患者经历更大的终生残留抑郁症状，这可能对认知功能领域有特别的影响。
INTRODUCTIONIt is well established that patients with bipolar disorder experience functional impairment even in remission. Nevertheless, bipolar II disorder remains understudied because most investigations to date include only bipolar I patients or just a small sample of bipolar II patients, without explicitly comparing both subtypes of disorder. The main objective of the current report is to evaluate overall and multiple domains of functioning, specifically in bipolar II disorder compared to patients with bipolar I disorder and healthy subjects.METHODS233 subjects from 3 groups were compared: bipolar I patients (n=106), bipolar II patients (n=66) and healthy controls (n=61). Bipolar patients meeting criteria of remission were recruited at the Hospital Clinic of Barcelona and at different study sites in Argentina. All participants were assessed with 17-item Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS) and the Functioning Assessment Short Test (FAST). Clinical and sociodemographic data were also recorded.RESULTSBoth subgroups of patients, bipolar I and bipolar II, showed lower overall functioning (p<0.001) and in each domain of the FAST scale (all, p<0.001) when compared to the healthy control group. Tukey post hoc test revealed that bipolar II patients scored worse in the cognitive domain compared to bipolar I patients. However, after controlling for potential confounding variables, this difference disappeared and only older age (p<0.005) and HAM-D scores (p<0.001) remained significant.CONCLUSIONSOur results suggest that bipolar II patients are as disabled as bipolar I patients. This may be explained, in part, because bipolar II patients experience greater lifetime residual depressive symptoms than the bipolar I subgroup, which may have particular impact on cognitive domains of functioning.