Residual symptom recovery from major affective episodes in bipolar disorders and rapid episode relapse/recurrence
Residual symptom recovery from major affective episodes in bipolar disorders and rapid episode relapse/recurrence
复制标题
DOI：
10.1001/archpsyc.65.4.386
复制
发表时间：
2008-04-01
影响因子：
--
通讯作者：
Solomon, David A.
中科院分区：
文献类型：
--
作者：
Judd, Lewis L.;Schettler, Pamela J.;Solomon, David A.
背景：双相情感障碍I型和11型的特点是频繁的情感发作复发和/或复发。越来越重要的治疗目标是通过预防或延迟额外的发作来减少慢性化。目的：确定双相情感障碍中主要情感发作恢复期间亚综合征残留症状的持续存在是否与发作复发明显快于无症状恢复相关，以及这是否是13个变量中与早期发作复发最强的相关性。设计：一项正在进行的对心境障碍的前瞻性、自然主义和系统性的20年随访调查：国家精神卫生研究所抑郁症协作研究。223名双相情感障碍患者（I型或II型）进行了前瞻性随访，中位时间为17年（平均14.1岁[标准差6.21岁]）。根据研究诊断标准定义为从指数重度抑郁发作中恢复的受试者和/或结果：有残余情感症状的恢复者比无症状恢复者经历随后的主要情感发作快3倍以上（危险比，3.36; 95%可信区间，2.254.98; P
Context: Both bipolar disorder type I and type 11 are characterized by frequent affective episode relapse and/or recurrence. An increasingly important goal of therapy is reducing chronicity by preventing or delaying additional episodes.Objectives: To determine whether the continued presence of subsyndromal residual symptoms during recovery from major affective episodes in bipolar disorder is associated with significantly faster episode recurrence than asymptomatic recovery and whether this is the strongest correlate of early episode recurrence among 13 variables examined.Design: An ongoing prospective, naturalistic, and systematic 20-year follow-up investigation of mood disorders: the National Institute of Mental Health Collaborative Depression Study.Setting: Five academic tertiary care centers Participants: Two hundred twenty-three participants with bipolar disorder (type I or II) were followed up prospectively for a median of 17 years (mean, 14.1 [SD, 6.21 years).Main Outcome Measure: Participants defined as recovered by Research Diagnostic Criteria from their index major depressive episode and/or mania were divided into residual vs asymptomatic recovery groups and were compared according to the time to their next major affective episodes.Results: Participants recovering with residual affective symptoms experienced subsequent major affective episodes more than 3 times faster than asymptomatic recoverers (hazard ratio, 3.36; 95% confidence interval, 2.254.98; P