CAUSES AND TREATMENTS OF RAPID CYCLING AFFECTIVE DISORDERS

情感性疾病倾向于自发地缓解和复发 频率越来越高。它的过程还具有以下特点： 有紧跟在躁狂发作之前或之后的倾向 通过抑郁发作，没有干预的正常时期，和 躁狂与抑郁交替出现。在快速骑行中的情感 混乱这些倾向是如此明显，以至于狂热和 抑郁症有规律地、频繁地复发， 循环航道。快速自行车案例约占15% 锂或情感障碍诊所的患者，他们是 很难治疗。这个项目的目的是为了 对快速骑行的原因和治疗的进一步认识 通过比较快速循环获得的数据来研究情感障碍 和非快周期患者的临床表现 特征和病程。所有快速骑自行车的患者 从1973年起进入我们的研究计划的人包括在 学习。为了进行比较，还设置了非快速骑行对照组 调查过了。关于患者的精神和心理健康状况的信息 病史，家族史，疾病原因，以及 对治疗的反应来自医院图表，研究 包含预期每日情绪评级记录的流程图， 治疗和程序，以及有组织的后续访谈。 我们发现1)快速循环型情感障碍是典型的 在基因上与更典型的双相情感障碍有关 疾病；2)甲状腺疾病在#年发病率很高。 快速循环和非快速循环中的锂处理 女性；3)尽管几乎所有的快速自行车患者都是 女性，没有令人信服的证据表明快速周期 由月经周期产生；4)抗抑郁剂治疗 药物与可逆的快速循环有关 50%的快速循环患者；患者经历了播种或 停药后停止骑自行车。这个 观察到抗抑郁药物可能是 在一半的情况下，快速骑自行车显然意味着 对快速骑行的防治，提供了线索 快速骑行可能的神经化学原因。

Affective illness tends to remit and recur spontaneously and with increasing frequency. Its course is also characterized by a tendency for manic episodes to be immediately preceded or followed by depressive episodes, with no intervening normal period, and for mania to alternate with depression. In rapid cycling affective disorder these tendencies are so pronounced that mania and depression recur regularly and frequently with a continuous, circular course. Rapid cycling cases comprise about 15% of patients in lithium or affective disorder clinics, and they are difficult to treat. The purpose of this project was to gain further insights into the causes and treatments of rapid cycling affective disorder by comparing data obtained from rapid cycling and non-rapid cycling patients with regard to their clinical features and course of illness. All rapid cycling patients admitted to our research program since 1973 were included in the study. For comparison, a non-rapid cycling control group was also investigated. Information regarding the patients' psychiatric and medical histories, family histories, cause of illness, and responses to treatments was derived from hospital charts, research flow charts containing records of prospective daily mood ratings, treatments and procedures, and structured follow-up interviews. We found that 1) rapid cycling affective disorder is phenotypically and genetically related to more typical forms of bipolar affective disorder; 2) there was a high prevalence of thyroid disease during lithium treatment in both rapid cycling and non-rapid cycling women; 3) although nearly all the rapid cycling patients were women, there was no convincing evidence that the rapid cycles were generated by the menstrual cycle; 4) treatment with antidepressant drugs was associated with reversible rapid cycling in approximately 50% of the rapid cycling patients; patients experienced sowing or cessation of cycling when the drugs were withdrawn. The observation that antidepressants may have been responsible for rapid cycling in half the cases has obvious implications for prevention and treatment of rapid cycling, and it provides a clue to possible neurochemical causes of rapid cycling.