Prospective study of rapid cycling affective disorder

据我们所知，只有两项前瞻性研究调查了快速循环情感障碍的预后，结果差异很大。因此，快速循环的预后意义仍然是一个重要的问题。我们跟踪了30名快速循环患者，他们接受了积极的锂、卡马西平治疗，有时还联合其他药物。在这30人中，有14人在第一年内迅速停止骑自行车。另一方面，剩下的16辆继续快速循环。他们的治疗反应因强化治疗前快速循环的持续时间而异。我们还通过在地塞米松试验中测定尿游离皮质醇来评估快速循环患者的下丘脑-垂体-肾上腺皮质轴功能。我们的结果显示，快速循环患者在低躁狂期的尿游离皮质醇水平低于抑郁期。本研究证实了下丘脑-垂体-肾上腺皮质轴功能随快周期患者情绪状态变化的假说。

To our knowledge, there are only two prospective studies which have investigated the prognosis of rapid cycling affective disorder and their results vary quite considerably. Thus, the prognostic significance of rapid cycling remains an important question.We followed up 30 rapid cyclers who were treated aggressively with lithium, carbamazepine and sometimes in combination with other drugs. Of these 30, fourteen stopped cycling rapidly within the first year. On the other hand, the remaining sixteen comtinued to cycle rapidly. Their treatment responses differ accordingly to the duration of rapid cycling prior to intensive treatment.We also assessed hypothalamic-pituitary-adrenocortical axis function in patients with rapid cycling by measuring urinary free cortisol in the dexamethasone test. Our results show that rapid cycling patients have lower urinary free cortisol levels during hypomanic phases than during depressive phases. The present study confirmed the hypothesis that hypothalamic-pituitrary-adrenocortical axis function varies with the mood states of rapid cycling patients.