Secondary mania in older adults
Secondary mania in older adults
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DOI：
10.1176/appi.ajp.162.11.2033
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发表时间：
2005-11-01
影响因子：
17.7
通讯作者：
Hoblyn, JC
中科院分区：
文献类型：
--
作者：
Brooks, JO;Hoblyn, JC
尽管躁狂症通常与双相情感障碍相关，但其病因可能有很多 (1)。因此，“原发性躁狂”是由双相情感障碍引起的，而“继发性躁狂”是由药理学、代谢或神经系统原因引起的 (1, 2)。由于合并症和神经系统变化的增加，老年人面临继发性躁狂的风险。在一项对 50 名年龄超过 65 岁的躁狂患者的回顾性研究中，28% 的患者是第一次躁狂发作，71% 患有共病神经系统疾病 (3)。躁狂的病因很重要，因为尽管原发性和继发性躁狂的急性症状治疗可能相似，但继发性躁狂的适当治疗包括解决病因 (1)。我们在此介绍两个老年人继发性躁狂的病例史，依次讨论他们的表现和鉴别诊断，并讨论治疗。
Although mania is commonly associated with bipolar disorder, it can have many etiologies (1). Thus,“primary mania” results from bipolar disorder, whereas “secondary mania” results from pharmacological, metabolic, or neurologic causes (1, 2). Older adults are at risk for secondary mania because of increased medical comorbidities and neurological changes. In one retrospective study of 50 patients with mania who were older than 65 years, it was the first manic episode for 28% of the patients and 71% had a comorbid neurological disorder (3). The etiology of mania is important because although acute symptomatic treatment of both primary and secondary mania may be similar, appropriate treatment of secondary mania includes addressing the cause (1). We present here two case histories of secondary mania in older adults, discuss their presentations and differential diagnosis in turn, and discuss treatment.