Clinical features of bipolar depression versus major depressive disorder in large multicenter trials
Clinical features of bipolar depression versus major depressive disorder in large multicenter trials
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DOI：
10.1176/appi.ajp.163.2.225
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发表时间：
2006-02-01
影响因子：
17.7
通讯作者：
Nierenberg, AA
中科院分区：
文献类型：
--
作者：
Perlis, RH;Brown, E;Nierenberg, AA
目的：未能认识到双相情感障碍的患者谁经历了严重的抑郁发作可能会导致不适当的治疗和较差的结果。能够区分双相抑郁和单相抑郁的临床特征将有助于更适当的治疗选择。方法：作者使用的数据来自参加了在美国进行的三个大型多中心临床试验的非精神病门诊患者，用于治疗重度抑郁发作，比较477例诊断为双相障碍的受试者和1,074例重度抑郁障碍。结果：双相抑郁症与双相情感障碍家族史、发病年龄早、既往抑郁发作次数多、蒙哥马利-阿斯伯格抑郁评定量表和汉密尔顿焦虑评定量表上的8个单项症状有关。恐惧在双相情感障碍患者中更常见，而悲伤;失眠;智力（认知），躯体（肌肉），呼吸，泌尿生殖系统的投诉;和抑郁行为在单相抑郁症患者中更常见。Logistic回归模型正确分类86.9%的subjects.Conclusions：双相抑郁症和抑郁症表现出微妙的差异，在介绍，这可能有助于指导初步诊断。
Objective: Failure to recognize bipolar disorder in patients who experience a major depressive episode may lead to inappropriate treatment and poorer outcomes. Clinical features that could distinguish bipolar from unipolar depression would facilitate more appropriate treatment selection.Method: The authors used data from nonpsychotic outpatients participating in three large multicenter clinical trials conducted in the United States for the treatment of major depressive episodes to compare 477 subjects with a diagnosis of bipolar disorder and 1,074 with major depressive disorder.Results: Bipolar depression was associated with family history of bipolar disorder, an earlier age at onset, a greater previous number of depressive episodes, and eight individual symptom items on the Montgomery-Asberg Depression Rating Scale and the Hamilton Anxiety Rating Scale. Fears were more common in patients with bipolar disorder, whereas sadness; insomnia; intellectual (cognitive), somatic (muscular), respiratory, genitourinary complaints; and depressed behavior were more common in patients with unipolar depression. A logistic regression model correctly classified 86.9% of the subjects.Conclusions: Bipolar depression and major depressive disorder exhibit subtle differences in presentation, which may help guide the initial diagnosis.