Major depressive disorder with subthreshold bipolarity in the National Comorbidity Survey Replication.
Major depressive disorder with subthreshold bipolarity in the National Comorbidity Survey Replication.
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DOI：
10.1176/appi.ajp.2010.09071011
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发表时间：
2010-10
期刊：
影响因子：
--
通讯作者：
Merikangas KR
中科院分区：
文献类型：
--
作者：
Angst J;Cui L;Swendsen J;Rothen S;Cravchik A;Kessler RC;Merikangas KR
越来越多的临床和流行病学证据表明，主要情绪障碍形成了从严重抑郁障碍(MDD)到单纯躁狂症的一系列疾病。目前的研究在国家共病调查复制(NCS-R)中检测了阈值以下双极与单纯MDD的MDD的患病率和临床相关性。NCS-R是2001年2月至2003年4月期间对美国人口进行的具有全国代表性的面对面家庭调查。使用世界卫生组织综合国际诊断访谈3.0版收集情绪障碍的终生病史、症状和临床严重程度指标，这是一种完全结构化的业馀诊断性访谈。有严重抑郁障碍病史的研究参与者中，近40%有亚临界值轻躁狂史。与没有轻躁狂史的患者相比，这一亚组患者的疾病起病年龄更早，抑郁发作次数更多，共病发生率更高，临床严重程度也比双相II型障碍患者更低。研究结果显示了重度抑郁障碍的异质性，并支持将阈值下躁狂症纳入诊断分类的有效性。双相情感障碍标准的扩大将对研究和临床实践产生重要影响。
There is growing clinical and epidemiologic evidence indicating that major mood disorders form a spectrum from Major Depressive Disorder (MDD) to pure mania. The present investigation examined the prevalence and clinical correlates of MDD with sub-threshold bipolarity vs. pure MDD in the National Comorbidity Survey Replication (NCS-R). The NCS-R is a nationally representative face-to-face household survey of the U.S. population conducted between February, 2001 and April, 2003. Lifetime history of mood disorders, symptoms and clinical indicators of severity were collected using version 3.0 of the WHO Composite International Diagnostic Interview, a fully structured lay-administered diagnostic interview. Nearly 40% of study participants with a history of major depressive disorder had a history of sub-threshold hypomania. This subgroup had a younger age of disorder onset, more episodes of depression, and higher rates of comorbidity than those without a history of hypomania, and lower levels of clinical severity than those with bipolar II disorder. The findings demonstrate heterogeneity of major depressive disorder and support the validity of inclusion of sub-threshold mania in the diagnostic classification. The broadening of criteria for bipolar disorder would have important implications for research and clinical practice.
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影响因子：
6.7
作者：
Licht, R. W.;Gijsman, H.;Angst, J.
通讯作者：
Angst, J.
影响因子：
--
作者：
Kessler, RC;Berglund, P;Walters, EE
通讯作者：
Walters, EE
影响因子：
6.6
作者：
Hantouche, EG;Akiskal, HS;Châtenet-Duchêne, L
通讯作者：
Châtenet-Duchêne, L
影响因子：
6.6
作者：
Akiskal, HS;Bourgeois, ML;Hirschfeld, R
通讯作者：
Hirschfeld, R
影响因子：
6.6
作者：
Angst, J;Gamma, A;Rössler, W
通讯作者：
Rössler, W