Gender and Depressive Symptoms in 711 Patients With Bipolar Disorder Evaluated Prospectively in the Stanley Foundation Bipolar Treatment Outcome Network
Gender and Depressive Symptoms in 711 Patients With Bipolar Disorder Evaluated Prospectively in the Stanley Foundation Bipolar Treatment Outcome Network
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DOI：
10.1176/appi.ajp.2009.09010105
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发表时间：
2010-06-01
影响因子：
17.7
通讯作者：
Zermeno, Melanie
中科院分区：
文献类型：
--
作者：
Altshuler, Lori L.;Kupka, Ralph W.;Zermeno, Melanie
目的：作者评估了双相情感障碍患者抑郁、躁狂或情绪正常的临床就诊比例的性别差异。方法：对711例双相I型或II型情感障碍患者的数据进行了分析，这些患者前瞻性随访7年以上（13，191次就诊）。主要的结果措施是抑郁症或轻躁狂或躁狂症状的存在，通过抑郁症症状量表和杨氏躁狂评定量表测量。数据分析使用三个独立的重复测量回归与逻辑链接函数模型的概率，一个人是抑郁症，躁狂症，或情绪正常。模型控制双相I或双相II诊断，快速循环，年龄，时间在研究中，共病焦虑症，共病物质使用disorders.Results：在大约一半的访问，患者有抑郁，躁狂，或轻躁狂症状。女性出现抑郁症状的可能性明显高于男性。这是由于女性快速循环和焦虑症的发病率较高，每一种都与抑郁症的发病率增加有关。所有患者组表现出增加的次数euthymic访问和抑郁和躁狂症状的访问次数减少，随着时间的增加，在study.Conclusions：双相情感障碍患者花了相当大的比例，他们的时间生病。存在显著的性别差异，妇女在抑郁极的就诊比例更大。这一发现似乎与快速循环和焦虑症的相应差异有关。(Am J Psychiatry 2010; 167：708-715）
Objective: The authors assessed gender differences in the proportion of clinical visits spent depressed, manic, or euthymic in patients with bipolar disorder.Method: Data were analyzed from 711 patients with bipolar I or II disorder who were followed prospectively over 7 years (13,191 visits). The main outcome measures were the presence of symptoms of depression or of hypomania or mania, measured by the Inventory of Depressive Symptomatology and the Young Mania Rating Scale. Data were analyzed using three separate repeated-measures regressions with a logistic link function to model the probability that an individual was depressed, manic, or euthymic. The models controlled for bipolar I or bipolar II diagnosis, rapid cycling, age, time in the study, comorbid anxiety disorders, and comorbid substance use disorders.Results: In approximately half of visits, patients had depressive, manic, or hypomanic symptoms. The likelihood of having depressive symptoms was significantly greater for women than for men. This was accounted for by higher rates in women of rapid cycling and anxiety disorders, each of which was associated with increased rates of depression. All patient groups showed an increase in number of euthymic visits and a decrease in number of visits with depressive and manic symptoms with increased time in study.Conclusions: Bipolar patients spend a substantial proportion of their time ill. Significant gender differences exist, with women spending a greater proportion of their visits in the depressive pole. This finding appears to be related to the corresponding differences in rates of rapid cycling and anxiety disorders. (Am J Psychiatry 2010; 167:708-715)