Patterns of sensitisation in the course of affective illness -: A life-charting study of treatment-refractory depressed patients
Patterns of sensitisation in the course of affective illness -: A life-charting study of treatment-refractory depressed patients
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DOI：
10.1016/s0165-0327(01)00328-7
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发表时间：
2002-06-01
影响因子：
6.6
通讯作者：
Ågren, H
中科院分区：
文献类型：
--
作者：
Ehnvall, A;Ågren, H
背景资料：波斯特及其合作者提出了一个随着时间推移的“敏感化”过程--随着时间的推移，情感性疾病的病程表现出更频繁、更深、更少与压力相关的发作趋势。本研究的主要目的是使用瑞典生命图表程序来检验致敏假设。研究方法：30例难治性情感障碍患者，其中4例有双相I型障碍，首先采访了使用半结构化的采访手册，包括事件，治疗和压力。然后招募所有以前的精神病记录。来自记录和访谈的信息被合并到个人的、回顾性的生命图表中。结果：20例患者表现为致敏过程，10例患者表现为非致敏过程。在这两组中，几乎90%的疾病发作都接受了治疗。致敏组自情感障碍发作以来的患病时间约为33%，非致敏组超过50%。局限性：研究的回顾性是一个局限性。结果适用于严重的难治性情感障碍患者，可能无法推广到一般患者较轻的情绪障碍。结论：我们的研究结果部分验证了情感敏感化的后假设，证明了超过一半的情感复发患者存在这种现象。然而，有相当一部分人明显是非致敏者，表现出稳定但更恶性的病程。未来的研究需要阐明这两组患者是否受益于不同的治疗。(C)2002 Elsevier Science B. V.保留所有权利。
Background: A 'sensitisation' process over time has been suggested by Post and collaborators - the affective illness course shows a tendency towards more frequent, deeper, and less stress-related episodes over time. The main aim of the present study was to test the sensitisation hypothesis using a Swedish Life Charting program. Methods: Thirty patients with treatment-refractory affective disorder, of whom four had bipolar I disorder, were first interviewed using a semistructural interview manual covering episodes, treatment and stress. All previous psychiatric records were then recruited. Information from the records and from the interview was coalesced into individual, retrospective life charts. Results: Twenty patients showed a sensitisation course and 10 patients showed a non-sensitisation course. In both groups, almost 90% of illness episodes had undergone treatment. Time spent in illness since onset of the affective disorder was about 33% for the sensitisation group and more than 50% for the non-sensitisation group. Limitations: The retrospective nature of the study is a limitation. The results apply to patients with severe treatment-refractory affective disorder and may not be generalisable to general patients with less-severe mood disorders. Conclusions: Our results partially validate the Post hypothesis of affective sensitisation in demonstrating this phenomenon in more than half of our affectively recurring patients. However, a substantial minority were clearly non-sensitisers showing a stable but more malignant illness course. Future studies need to elucidate whether these two groups benefit from different kinds of treatment. (C) 2002 Elsevier Science B.V. All rights reserved.