Prospective predictors of mood episodes in bipolar disorder.
Prospective predictors of mood episodes in bipolar disorder.
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DOI：
10.1016/j.jad.2011.06.060
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发表时间：
2011-12
影响因子：
6.6
通讯作者：
Brenner CA
中科院分区：
文献类型：
--
作者：
Kam JW;Bolbecker AR;O'Donnell BF;Hetrick WP;Brenner CA
双相情感障碍（BD）与情绪、人格、认知和事件相关电位（ERP）测量的改变有关。这些多方面的措施之间的关系的状态和随后的过程中的疾病还没有得到很好的理解。因此，本研究旨在前瞻性地确定预测情绪发作过程的因素。65例BD患者在基线时接受听觉P300 oddball任务，临床评估工具和认知测试，随后每月通过电话进行一次SCID访谈，持续12个月。分层回归分析表明，蒙哥马利-艾斯伯格抑郁评定量表（MADRS）预测了处于抑郁状态（p<.001）和混合状态（p=.001）的月数，而MADRS（p<.001）和完成试验A的时间（p=.033）预测了情绪发作（所有情绪状态）的总月数。在入组时的心境正常患者中，考克斯回归分析表明，MADRS（p= 0.017）和轻躁狂人格量表（HPS; p<0.001）的评分越高，情绪发作的可能性越高，且距情绪发作的时间越短。样本量相对较小，并非所有参与者都完成了12个月的随访，并且通过电话进行了随访评估。我们的研究结果表明，情感和认知的措施，人格因素，特别是MADRS和HPS，作为重要的预测因素的过程中情绪发作或复发的BD患者。这些急性情绪状态的前瞻性标志物可用于指导治疗决策。
Bipolar disorder (BD) is associated with alterations in mood, personality, cognition and event-related potential (ERP) measures. The relationship between these multidimensional measures of state and subsequent course of the illness is not well understood. Therefore, this study aimed to prospectively identify factors that predicted the course of mood episodes. Sixty-five participants with BD were administered the auditory P300 oddball task, clinical assessment instruments and cognitive tests at baseline, and were subsequently administered the SCID interview once a month by telephone for 12 months. Hierarchical regression analyses indicated that the Montgomery-Asberg Depression Rating Scale (MADRS) predicted the number of months spent in a depressed state (p<.001) and in a mixed state (p=.001), while both the MADRS (p<.001) and time to complete Trails A (p=.033) predicted total number of months in a mood episode (across all mood states). Among euthymic patients at entry, Cox regression analyses indicated that higher ratings on both the MADRS (p=.017) and Hypomania Personality Scale (HPS; p<.001) were associated with both increased likelihood of a mood episode and less time until the onset of a mood episode. The sample size is relatively small, not all participants completed 12 months, and follow-up assessments were conducted via telephone. Our results suggest that affective and cognitive measures, and personality factors, especially the MADRS and HPS, serve as important predictors of the course of mood episodes or relapse in BD patients. These prospective markers of acute mood states may be used to guide treatment decisions.
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