Are impulse-control disorders related to bipolar disorder?
Are impulse-control disorders related to bipolar disorder?
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DOI：
10.1016/s0010-440x(96)90001-2
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发表时间：
1996-07-01
影响因子：
7.3
通讯作者：
Strakowski, SM
中科院分区：
文献类型：
--
作者：
McElroy, SL;Pope, HG;Strakowski, SM
我们回顾了关于冲动控制障碍（ICDs）和双相情感障碍之间可能关系的现有证据。对icd的现象学、病程、合并症、家族史、生物学和治疗反应的研究与双相情感障碍的类似研究进行了比较。虽然没有研究直接比较ICD患者和情绪障碍患者，但现有数据表明ICD和双相情感障碍具有许多特征：(1)现象上的相似性，包括有害的、危险的或愉快的行为、冲动、类似的情感症状和失调；(2)青春期或成年早期发病，并有发作性和/或慢性病程；（三）与其他精神障碍有高度合并症或相似合并症的；(4)家族性情绪障碍发生率升高；(5)中枢5 -羟色胺能和去甲肾上腺素能神经传递可能异常；(6)对情绪稳定剂和抗抑郁药的反应。然而，icd和双相情感障碍在重要方面有所不同。特别是，一些icd可能与强迫症（OCD）的关系比双相情感障碍更密切。虽然icd和双相情感障碍之间的相似性可能是巧合，但它们表明这两种疾病可能是相关的，因此可能至少有一种共同的病理生理异常。为了解释这种可能的关系，我们假设冲动性和双极性（或躁狂）是相关的，强迫性和单极性（或抑郁）是类似的相关，并且每种状态可能代表相关的对立极性，甚至是单一的心理维度。版权所有(C) 1996年由W.B.桑德斯公司
We reviewed available evidence regarding a possible relationship between impulse-control disorders (ICDs) and bipolar disorder. Studies examining the phenomenology, course, comorbidity, family history, biology, and treatment response of ICDs were compared with similar studies of bipolar disorder. Although no studies directly compare a cohort of ICD patients with a cohort of mood disorder patients, available data suggest that ICDs and bipolar disorder share a number of features: (1) phenomenologic similarities, including harmful, dangerous, or pleasurable behaviors, impulsivity, and similar affective symptoms and dysregulation; (2) onset in adolescence or early adulthood and episodic and/or chronic course; (3) high comorbidity with one another and similar comorbidity with other psychiatric disorders; (4) elevated familial rates of mood disorder; (5) possible abnormalities in central serotonergic and noradrenergic neurotransmission; and (6) response to mood stabilizers and antidepressants. However, ICDs and bipolar disorder differ in important respects. In particular, some ICDs may be more closely related to obsessive-compulsive disorder (OCD) than is bipolar disorder. Although the similarities between ICDs and bipolar disorder may be coincidental, they suggest that the two conditions may be related and thus may share at least one common pathophysiologic abnormality. To explain this possible relationship, we hypothesize that impulsivity and bipolarity (or mania) are related, that compulsivity and unipolarity (or depression) are similarly related, and that each state may represent opposing poles of related, or even a single, psychological dimension. Copyright (C) 1996 by W.B. Saunders Company