Differences between bipolar I and bipolar II disorders in clinical features, comorbidity, and family history
Differences between bipolar I and bipolar II disorders in clinical features, comorbidity, and family history
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DOI：
10.1016/j.jad.2010.11.020
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发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Hong, Kyung Sue
中科院分区：
文献类型：
--
作者：
Baek, Ji Hyun;Park, Dong Yeon;Hong, Kyung Sue
背景资料：本研究的目的是探讨是否双相II型障碍（BP-II）有不同的特点，从双相I型障碍（BP-I），不仅在躁狂的严重程度，但也在临床特征，先前的过程中，合并症，和家族史，足以提供其疾病分类分离BP-I。方法：综合临床评价的基础上，从普通的临床设置的信息。71 BP-I和34 BP-II患者进行了评估，使用遗传学研究诊断访谈，韩国版本。先证者的一级亲属（n =374）的精神病学评估进行了使用修改后的版本的家族史研究诊断标准。结果：抑郁发作的频率是较高的BP-II（p = 0.009）相比，BP-I。此外，季节性（p=0.035）和快速循环过程（p=0.062）在BP-H中更常见。在躁狂表现方面，BP-II以“兴奋情绪”为主，而BP-I则以“兴奋情绪”和“烦躁情绪”为主。至于抑郁症状，精神激越，内疚感和自杀意念更常见于BP-II。BP-II患者表现出较高的趋势，终生共同出现的轴诊断（p = 0.09），和一个显着较高的发病率恐怖症和进食障碍。BP-I和BP-II一级亲属中精神疾病的总体发生率分别为15.4%和26.5%（p = 0.01）。重度抑郁症（p = 0.005）和物质相关性障碍（p = 0.051）是更普遍的亲属的BP-II先证者。结论：在目前的研究中确定的BP-II的独特的特点，可以通过，以方便鉴别诊断的BP-I和BP-II在普通的临床设置。(C)2010爱思唯尔有限公司版权所有。
Background: The present study was designed to investigate whether bipolar II disorder (BP-II) has different characteristics from bipolar I disorder (BP-I), not only in manic severity but also in clinical features, prior course, comorbidity, and family history, sufficiently enough to provide its nosological separation from BP-I.Methods: Comprehensive clinical evaluation was performed based on information available from ordinary clinical settings. Seventy-one BP-I and 34 BP-II patients were assessed using the Diagnostic Interview for Genetic Studies, Korean version. Psychiatric assessment for first-degree relatives (n =374) of the probands was performed using the modified version of the Family History-Research Diagnostic Criteria.Results: The frequency of depressive episodes was higher in BP-II (p = 0.009) compared to BP-I. Further, seasonality (p=0.035) and rapid-cycling course (p=0.062) were more common in BP-H. Regarding manic expression, 'elated mood' was predominant in BP-II whereas 'elated mood' and 'irritable mood' were equally prevalent in BP-I. With regard to depressive symptoms, psychomotor agitation, guilty feeling, and suicidal ideation were more frequently observed in BP-II. BP-II patients exhibited a higher trend of lifetime co-occurrence of an axis diagnosis (p = 0.09), and a significantly higher incidence of phobia and eating disorder. The overall occurrence rate of psychiatric illness in first-degree relatives was 15.4% in BP-I and 26.5% in BP-II (p = 0.01). Major depression (p = 0.005) and substance-related disorder (p = 0.051) were more prevalent in relatives of BP-II probands.Conclusion: Distinctive characteristics of BP-II were identified in the current study and could be adopted to facilitate the differential diagnosis of BP-I and BP-II in ordinary clinical settings. (C) 2010 Elsevier B.V. All rights reserved.