Psychotic features in bipolar and unipolar depression
Psychotic features in bipolar and unipolar depression
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DOI：
10.1111/j.1399-5618.2007.00460.x
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发表时间：
2007-12-01
影响因子：
5.4
通讯作者：
Potash, James B.
中科院分区：
文献类型：
--
作者：
Goes, Fernando S.;Sadler, Bradley;Potash, James B.
虽然之前的一些研究发现双相情感障碍患者或双相情感障碍亲属的精神病性抑郁症发病率较高，但其他研究未能证实这些观察结果。我们在几个大型情绪障碍家族样本中研究了精神病性抑郁与极性的关系。 在三项关于 I 型双相情感障碍 (BPI) 或复发性重度抑郁症 (MDDR) 遗传学的家庭研究中，临床医生对总共 4,724 名患有重度情绪障碍的受试者进行了半结构化访谈。精神病特征的确定是基于情感障碍和精神分裂症终身版时间表或遗传研究诊断访谈中最严重抑郁发作期间的幻觉和/或妄想报告。按诊断类别计算精神病性抑郁症的发生率，并使用广义估计方程对研究内和研究间的诊断进行比较。与 MDDR 相比，BPI 障碍的诊断可以强烈预测抑郁症期间的精神病性特征 [比值比 (OR) = 4.61，p < 0.0005]。与 MDDR 相比，患有双相 II 型并不能预测精神病（OR = 1.05，p = 0.260），MDDR 受试者中有 BPI 家族史也不能预测精神病（OR = 1.20，p = 0.840）。抑郁发作期间的精神病特征增加了 BPI 诊断的可能性。需要前瞻性研究来证实这些发现。精神病性抑郁症的潜在遗传基础值得进一步研究。
While some prior studies have found higher rates of psychotic depression in those with bipolar disorder or a bipolar relative, others have failed to confirm these observations. We examined the relationship of psychotic depression to polarity in several large familial samples of mood disorder.A total of 4,724 subjects with major mood disorder in three family studies on the genetics of bipolar I disorder (BPI) or recurrent major depressive disorder (MDDR) were administered semi-structured interviews by clinicians. Determination of psychotic features was based on a report of hallucinations and/or delusions during the most severe depressive episode in the Schedule for Affective Disorders and Schizophrenia-Lifetime Version or the Diagnostic Interview for Genetic Studies interview. Rates of psychotic depression were calculated by diagnostic category and comparisons were made between diagnoses within and across studies using the generalized estimating equation.A diagnosis of BPI disorder was strongly predictive of psychotic features during depression compared to MDDR [odds ratio (OR) = 4.61, p < 0.0005]. Having bipolar II compared to MDDR was not predictive of psychosis (OR = 1.05, p = 0.260), nor was having a family history of BPI in MDDR subjects (OR = 1.20, p = 0.840).Psychotic features during a depressive episode increased the likelihood of a BPI diagnosis. Prospective studies are needed to confirm these findings. The potential genetic underpinnings of psychotic depression warrant further study.