Rapid switching of mood in families with familial bipolar disorder.
Rapid switching of mood in families with familial bipolar disorder.
复制标题
患有家族性双相情感障碍的家庭的情绪快速转变。
DOI：
10.1111/j.1399-5618.2008.00600.x
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发表时间：
2008
影响因子：
5.4
通讯作者：
MacKinnon,DeanF
中科院分区：
文献类型：
--
作者：
Nwulia,EvaristusA;Zandi,PeterP;McInnis,MelvinG;DePauloJr,JRaymond;MacKinnon,DeanF
目的：双相情感障碍的快速情绪转换与发病年龄、惊恐共病和自杀倾向有关。本研究的目的是确认这些协会，并探讨其他潜在的相关因素的快速转换的情绪使用家庭从多站点双相linkage study.Methods：受试者包括1,143先证者和亲属诊断为双相情感障碍。所有受试者都直接与标准的诊断工具进行访谈，所有符合双相情感障碍标准的受试者都被问到他们的情绪是否曾经快速转换。结果：快速情绪转换的个体在发病时的年龄显著更早（18岁比21岁，p <0.00001），更高的共病焦虑（47%比26%，p <0.00001）和物质使用障碍（52%比42%，p = 0.0006），更高的暴力行为（6%比3%，p <0.004），自杀行为（46%比31%，p <0.00001）和非自杀性自我伤害（13%比6%，p <0.0002）。 多元逻辑回归分析发现，快速情绪转换对早期出现症状[比值比（OR） = 0.62; 95%置信区间（CI）：0.45-0.85]、焦虑合并症（OR = 2.31; 95% CI：1.34-3.98）和抗抑郁药过敏（OR = 2.05; 95%可信区间：1.49-2.83）作为最强的预测因子。结论：这证实了早期的报道，快速转换与更复杂的临床过程，特别是早期出现的双相情感障碍，抗抑郁药激活，焦虑合并症。这些结果支持双相情感障碍的临床分化为亚型的基础上症状的稳定性。
Objective:Rapid switching of moods in bipolar disorder has been associated with early age at onset, panic comorbidity, and suicidality. This study aims to confirm these associations and investigate other potential correlates of rapid switching of mood using families from a multisite bipolar linkage study.Methods:The subjects were comprised of 1,143 probands and relatives with diagnosis of bipolar disorder. All subjects were interviewed directly with a standard diagnostic instrument, and all subjects who met criteria for bipolar disorder were asked if their moods had ever switched rapidly.Results:Individuals with rapid mood switching had significantly earlier age at onset (18 versus 21 years, p < 0.00001), higher comorbid anxiety (47% versus 26%, p < 0.00001) and substance use disorders (52% versus 42%, p = 0.0006), higher rate of violent behavior (6% versus 3%, p < 0.004), suicidal behavior (46% versus 31%, p < 0.00001), and nonsuicidal self‐harm (13% versus 6%, p < 0.0002). Multiple logistic regression analysis found significant net effects on rapid mood switching for early emergence of symptoms [odds ratio (OR) = 0.62; 95% confidence interval (CI): 0.45–0.85]; anxiety comorbidity (OR = 2.31; 95% CI: 1.34–3.98); and hypersensitivity to antidepressants (OR = 2.05; 95% CI: 1.49–2.83) as the strongest predictors.Conclusions:This confirms earlier reports associating rapid switching with a more complex clinical course, in particular early emergence of bipolar symptomatology, antidepressant activation, and anxiety comorbidity. These results support a clinical differentiation of bipolar disorder into subtypes based on symptom stability.