THE NATIONAL DEPRESSIVE AND MANIC-DEPRESSIVE ASSOCIATION (DMDA) SURVEY OF BIPOLAR MEMBERS
THE NATIONAL DEPRESSIVE AND MANIC-DEPRESSIVE ASSOCIATION (DMDA) SURVEY OF BIPOLAR MEMBERS
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DOI：
10.1016/0165-0327(94)90104-x
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发表时间：
1994-08-01
影响因子：
6.6
通讯作者：
HIRSCHFELD, RMA
中科院分区：
文献类型：
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作者：
LISH, JD;DIMEMEENAN, S;HIRSCHFELD, RMA
全国抑郁症和躁狂抑郁症协会的成员谁有双相情感障碍进行了调查。59%的受访者在儿童或青少年时期首次出现症状。症状发作、寻求治疗和接受双相诊断之间的长时间延迟是常见的。45%的受访者目前经常复发。儿童/青少年发病与阳性家族史、抑郁或混合型初始症状和频繁复发相关，以抑郁症状为主。频繁复发与抑郁或混合初始症状和抑郁发作有关，但与药物不依从性无关。儿童/青少年发病和频繁复发与社会发病率增加有关，有效治疗可减少社会发病率。频繁复发的受访者不太可能接受情绪稳定剂治疗，更有可能接受抗抑郁药或抗焦虑药治疗，更有可能报告过去的焦虑症状和诊断。13%的受访者没有医疗保险，15%的人因经济原因未能服药。可通过以下措施加强对双相情感障碍的治疗：（a）公共卫生努力促进早期诊断和治疗;（B）确保对经常复发的患者进行充分的情绪稳定剂试验;（c）进一步研究具有突出焦虑症状的双相情感障碍;（c）改善获得精神保健的机会。
Members of the National Depressive and Manic-Depressive Association who have bipolar disorder were surveyed. 59% of respondents had their first symptoms during childhood or adolescence. Long delays between symptom onset, treatment-seeking, and receipt of a bipolar diagnosis were common. 45% of respondents currently experience frequent recurrences. Child/adolescent onset was associated with a positive family history, depressive or mixed initial symptoms, and frequent recurrence, with predominantly depressive symptoms. Frequent recurrences were associated with depressive or mixed initial symptoms and depressive episodes, but not with medication non-compliance. Both child/adolescent onset and frequent recurrence were associated with increased social morbidity, which was diminished by effective treatment. Respondents with frequent recurrences were less likely to be treated with mood-stabilizers, more likely to be treated with anti-depressants, or anxiolytics, and more likely to report past anxiety symptoms and diagnoses. 13% of respondents had no medical insurance, and 15% had failed to take medicine for financial reasons. The treatment of bipolar illness could be enhanced by (a) public health efforts to promote early diagnosis and treatment; (b) ensuring adequate trials of mood-stabilizers for patients with frequent recurrences; (c) further research on bipolar disorder with prominent anxiety symptoms; and (c) improved access to mental health care.