本研究旨在确定中国双相情感障碍(BD)患者前驱症状的临床特征。在第一次情感发作之前。它进一步旨在表征I型双相情感障碍(BD-I)和II型(BD-II)之间的前驱特征。
120名患有BD-I(n=92)和BD-II(n=28)的个体被招募到研究中。然后进行半结构化访谈以评估患者的前驱症状,BD发病后3年内,采用双相前驱症状回顾性量表(BPSS-R)。
在第一次抑郁发作的前驱阶段,与BD-I相比,BD-II患者的前驱症状更多(p=0.0028)。此外,与BD-I相比,BD-II患者的预测因子更常见,包括教育和职业功能障碍(p=0.0023),社会隔离(p<0.001),决策困难(p=0.0012),反对性(p=0.012),和可疑/迫害的想法(p=0.017)。前体的持续时间也存在差异。BD-I患者的“体重减轻或食欲下降”(p=0.016)持续时间更长,而“强迫症”(p=0.023)在BD-II患者中开始较早,并在抑郁前期发生。每个报告的前驱症状的患病率和持续时间,在第一次(轻度)躁狂发作之前,BD-I和BD-II患者之间无差异。
具体情感,一般,或精神病症状发生在两次情感发作之前。前驱症状的特征是BD后期发作的关键预测因子,包括减弱的躁狂症样症状,阈下抑郁情绪,情绪波动/不稳定,和焦虑。在抑郁前状态,与BD-II相比,BD-I在非特异性维度表现出更多的前驱症状,这表明BD-II的负担很大。总之,这项研究扩展了对BD-I和BD-II前驱体特征的理解。
This
study aimed to identify the clinical characteristic of prodromal symptoms in Chinese patients with bipolar disorder (BD), prior to the first affective episode. It further aimed to characterize the prodromal traits between bipolar disorder type I (BD-I) and type II (BD-II).
120 individuals with BD-I (n = 92) and BD- II (n = 28) were recruited to the
study. Semi-structured interviews were then administered to evaluate prodromal symptoms in patients, within 3 years of BD onset, by using the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R).
In the prodromal phase of the first depressive episode, patients with BD-II experienced more prodromal symptoms (p = 0.0028) compared to BD-I. Additionally, more frequent predictors were reported in patients with BD-II than BD-I including educational and occupational dysfunction (p = 0.0023), social isolation (p < 0.001), difficulty making decisions (p = 0.0012), oppositionality (p = 0.012), and suspiciousness/persecutory ideas (p = 0.017). There were also differences in the duration of the precursors. The duration of \"weight loss or decrease in appetite\" (p = 0.016) lasted longer in patients with BD-I, while \"obsessions and compulsions\" (p = 0.023) started earlier in patients with BD-II and occurred during the pre-depressive period. The prevalence and duration of each reported prodrome, preceding a first (hypo) manic episode, showed no difference between patients with BD-I and BD-II.
Specific affective, general, or psychotic symptoms occurred prior to both affective episodes. The characteristic of prodromal symptoms were key predictors for later episodes of BD including attenuated mania-like symptoms, subthreshold depressed mood, mood swings/lability, and anxiety. In the pre-depressive state, when compared to BD-II, BD-I presented with more prodromal symptoms in nonspecific dimensions, which indicated the substantial burden of BD-II. In conclusion, this
study extends the understanding of the characteristics of prodromes of BD-I and BD-II.