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双相抑郁障碍的临床特征研究进展(中)
作者: 徐贵云 苗国栋 党亚梅
单位:广州市精神病医院;
关键词: 双相障碍 抑郁发作 临床特征 综合征
分类号:
出版年·卷·期(页码):2008·34·第 12 期(0-0)
摘要:
双相抑郁障碍除了具有发病年龄、双相障碍家族史、抑郁发作次数、发病特点及症状表现等临床特征之外,还有其他的特点。本文将对双相障碍与各种综合征的关系进行综述。1.1非典型特征(atypical features,ATF)ATF是指具有非典型特征的抑郁发作,起初指优先对单胺氧化酶抑制剂有效者,后来研究发现具有ATF的抑郁症患者不同于无ATF者[1]。目前ATF标准仍不一致。美国精神障碍诊断与统计手册第4版(DSM-IV)的ATF标准为:符合重性抑郁发作(MDE)标准,同时具有情绪反应性,加上睡眠增多、食欲/体重增加、灌铅样麻痹、拒绝敏感性增加中至少2条[2]。使用DSM-IV标准的绝大多数研究中,MDD患者中ATF的发生率在四分之一到三分之一之间[1]。研究表明,非典型抑郁是双相II型障碍的一个较特异的指征。Posternak等[1]研究了579例MDE患者后发现,双相抑郁障碍(BDD)患者的心境反应性和拒绝敏感性明显比MDD的多,尽管两组的ATF总体发生率近似。有研究发现,双相障碍(bipolardisorder,BP)患者中ATF的发生率明显比重性抑郁症(MDD)患者高[3-4],具有非典型症状的MDD患者后来...
参考文献:

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