DOES SCREENING WITH THE MDQ AND EPDS IMPROVE IDENTIFICATION OF BIPOLAR DISORDER IN AN OBSTETRICAL SAMPLE?
DOES SCREENING WITH THE MDQ AND EPDS IMPROVE IDENTIFICATION OF BIPOLAR DISORDER IN AN OBSTETRICAL SAMPLE?
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DOI：
10.1002/da.22373
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发表时间：
2015-07-01
影响因子：
7.4
通讯作者：
Wisner, Katherine L.
中科院分区：
文献类型：
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作者：
Clark, Crystal T.;Sit, Dorothy K. Y.;Wisner, Katherine L.
女性双相情感障碍（BD）是产后情感发作和精神病的高危人群。虽然经过验证的筛查工具可用于产后单极抑郁症，但很少有筛查工具用于轻度躁狂/躁狂。产后BD的筛查工具对于提高发现和制定适当的治疗计划至关重要。我们评估在爱丁堡产后抑郁量表（EPDS）中加入情绪障碍问卷（MDQ）是否能增加产后早期双相障碍的识别。方法1279名分娩后4-6周EPDS和/或MDQ筛查呈阳性的活婴妇女接受了DSM-IV （SCID）的家庭结构化临床访谈。结果EPDS和/或MDQ筛查阳性的样本占12% （n = 155）。93名（60%）筛查阳性的母亲完成了SCID的家庭诊断访谈。37% （n = 34）的患者最初诊断为BD。EPDS和/或MDQ筛查阳性的BD女性如下：EPDS+/MDQ+ (n = 14), EPDS+/MDQ- (n = 17)和EPDS-/MDQ+ (n = 3)。MDQ确定了50%（17/34）的双相障碍妇女，当MDQ中关于母亲认为自己受损程度的问题被排除在筛查标准之外时，另外还有6例双相障碍病例。结论在EPDS中加入MDQ后，50%使用传统MDQ评分的女性在筛查水平上提高了单极抑郁症与双相抑郁症的区别，而在不使用损害标准的情况下进行MDQ评分的女性提高了近70%。(C) 2015 Wiley期刊公司
BackgroundWomen with bipolar disorder (BD) are at high risk for postpartum affective episodes and psychosis. Although validated screening tools are available for postpartum unipolar depression, few screening tools for hypomania/mania exist. Screening tools for BD in the postpartum period are essential for improving detection and planning appropriate treatment. We evaluated whether adding the Mood Disorders Questionnaire (MDQ) to the Edinburgh Postnatal Depression Scale (EPDS) increased the identification of BD in the early postpartum period.MethodsWomen (N = 1,279) who delivered a live infant and screened positive on the EPDS and/or MDQ at 4-6 weeks postbirth were invited to undergo an in-home Structured Clinical Interview for DSM-IV (SCID).ResultsPositive EPDS and/or MDQ screens occurred in 12% of the sample (n = 155). In home SCID diagnostic interviews were completed in 93 (60%) of the mothers with positive screens. BD was the primary diagnosis in 37% (n = 34). Women with BD screened positive on the EPDS and/or MDQ as follows: EPDS+/MDQ+ (n = 14), EPDS+/MDQ- (n = 17), and EPDS-/MDQ+ (n = 3). The MDQ identified 50% (17/34) of the women with BD and 6 additional cases of BD when the MDQ question regarding how impaired the mother perceived herself was excluded from the screen criterion.ConclusionAddition of the MDQ to the EPDS improved the distinction of unipolar depression from bipolar depression at the level of screening in 50% of women with traditional MDQ scoring and by nearly 70% when the MDQ was scored without the impairment criterion. (C) 2015 Wiley Periodicals, Inc.