Unipolar Mania: Prevalence and Patient Characteristics.

IF 5.3 2区 医学 Q1 PSYCHIATRY
Mirko Manchia, Alessandro Miola, Leonardo Tondo, Ross J Baldessarini
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引用次数: 0

Abstract

Objectives: Recurrent [hypo]mania without major depressive episodes ("unipolar mania" [UPM]) is an uncommon form of major affective disorder related to bipolar disorder (BD). We characterized UPM patients and estimated the prevalence of their characteristics based on prolonged times-at-risk.

Methods: Using standard bivariate and multivariate statistics, we compared the characteristics of 63 consecutive UPM patients to 1210 other BD patients over prolonged, close, prospective follow-up at expert mood disorder centers.

Results: UPM was uncommon (4.95% of 1273 BD cases during 18.2 years at risk) with a 2.5-fold excess of men and 93.4% considered type I BD. UPM cases had earlier initial clinical interventions than other BD patients, more psychotic features with first episodes, and fewer UPM patients were married but did not have fewer children and were more unemployed. UPM cases experienced more morbidity (episodes and hospitalizations/year and %-time ill) than other BD patients and made more follow-up clinic visits/year. They were less likely to be suicidal and had less general medical comorbidity but did not differ in substance abuse. They had lower ratings of depressive symptoms, used mood stabilizers more, and as expected, received antidepressants 27 times less than other BD patients. Observed rates of UPM declined with longer observation times.

Conclusions: UPM was uncommon (4.95% of BD cases; 0.31% with hypomania only). Compared to ordinary BD, UPM had significantly greater morbidity and unemployment but a lower risk of suicidal behavior or general medical disorders associated with bipolar depression. This unusual disorder needs greater recognition, clarification of its nosological status, and efforts to optimize its treatment.

单极躁狂:患病率和患者特征。
目的:无重性抑郁发作的复发性[轻度]躁狂(“单极躁狂”[UPM])是与双相情感障碍(BD)相关的一种罕见的主要情感障碍。我们对UPM患者进行了特征描述,并根据风险时间的延长估计了其特征的普遍性。方法:采用标准的双变量和多变量统计,我们比较了63名连续UPM患者和1210名其他BD患者在专家情绪障碍中心进行的长时间、密切、前瞻性随访的特征。结果:UPM并不常见(在18.2年的风险期中,1273例BD病例中有4.95%为UPM,其中男性多2.5倍,93.4%被认为是I型BD。UPM病例比其他BD患者有更早的初始临床干预,首发时有更多的精神病特征,UPM患者较少结婚,但没有更少的孩子,失业更多。UPM病例比其他BD患者有更高的发病率(发作和住院次数/年和%患病时间),并且每年有更多的随访诊所访问量。他们自杀的可能性更小,一般的医疗合并症也更少,但在药物滥用方面没有差异。他们的抑郁症状评分较低,更多地使用情绪稳定剂,并且正如预期的那样,接受抗抑郁药的人数比其他双相障碍患者少27倍。观察到的UPM率随着观察时间的延长而下降。结论:UPM不常见(4.95%;仅为轻躁狂0.31%)。与普通双相障碍相比,UPM的发病率和失业率明显更高,但自杀行为或与双相抑郁症相关的一般医学障碍的风险较低。这种不寻常的疾病需要更多的认识,澄清其病分学地位,并努力优化其治疗。
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来源期刊
Acta Psychiatrica Scandinavica
Acta Psychiatrica Scandinavica 医学-精神病学
CiteScore
11.20
自引率
3.00%
发文量
135
审稿时长
6-12 weeks
期刊介绍: Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.
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