主导极性在老年双相情感障碍中的作用。

IF 3.5 2区 医学 Q2 PSYCHIATRY
Constanza Sommerhoff, Marta Bort, Giulia D'Alessandro, Giovanna Fico, Michele De Prisco, Vincenzo Oliva, Brisa Solé, Carla Torrent, Andrea Murru, Andrea Ruiz, Arturo Rodríguez-Rey, Jose Sanchez-Moreno, Esther Jiménez, Anabel Martínez-Arán, Eduard Vieta, Laura Montejo
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引用次数: 0

摘要

主要极性(PP)已成为双相情感障碍(BD)的一个有价值的病程指标,对预后和治疗计划有影响。随着双相障碍人群的老龄化,了解其临床特征对于在整个生命周期中量身定制个性化干预变得至关重要。本研究旨在描述老年双相障碍(OABD)队列中PP亚组的分布和临床特征。方法:本横断面研究纳入101例年龄在100 ~ 50岁的健康OABD患者。临床、神经心理学和功能特征在抑郁(DPP)、躁狂(MPP)和未确定的主要极性(UPP)亚组之间进行比较,基于至少2/3的一生发作是抑郁或躁狂极性。结果:UPP是OABD中最常见的PP(59.4%),其次是DPP(27.7%)和MPP(12.9%)。DPP患者的发病年龄较晚,首发抑郁,精神住院较少,并且在视觉记忆方面有优于MPP和UPP的趋势。MPP患者更频繁地出现躁狂发作。与DPP相比,UPP亚组表现出更差的临床结果,包括更高的总发作次数、更频繁的自杀意念和季节性,以及更严重的经济残疾。结论:PP分类区分OABD有意义的临床亚群和认知亚群。UPP亚组与更严重的疾病和功能损害相关。这些发现支持将PP整合到老年双相障碍的个性化治疗和预防策略中。未来的纵向研究需要进一步阐明PP在整个生命周期中的发展轨迹。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of predominant polarity in older age bipolar disorder.

Introduction: Predominant polarity (PP) has emerged as a valuable course specifier in bipolar disorder (BD) with implications for prognosis and treatment planning. As the BD population ages, understanding its clinical characteristics becomes essential to tailor personalized interventions across the lifespan. This study aimed to characterize the distribution and clinical profiles of PP subgroups in a cohort of older adults with BD (OABD).

Methods: This cross-sectional study included 101 euthymic OABD aged >50 years. Clinical, neuropsychological and functional characteristics were compared between depressive (DPP), manic (MPP), and undetermined predominant polarity (UPP) subgroups, based on at least 2/3 of lifetime episodes being either depressive or manic polarity.

Results: UPP was the most frequent PP in OABD (59.4%), followed by DPP (27.7%) and MPP (12.9%). Patients with DPP presented a later age of onset, a depressive first episode, less psychiatric hospitalizations, and a trend to outperform MPP and UPP in visual memory. Participants with MPP presented more frequently with manic onset. The UPP subgroup exhibited worse clinical outcomes, including higher number of total episodes, more frequent suicidal ideation and seasonality, and worse financial disability compared to DPP.

Conclusion: PP classification distinguishes meaningful clinical and cognitive subgroups in OABD. The UPP subgroup associates with greater illness severity and functional impairment. These findings support the integration of PP into personalized treatment and prevention strategies in aging BD. Future longitudinal studies are needed to further clarify the trajectory of PP across the lifespan.

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来源期刊
International Journal of Bipolar Disorders
International Journal of Bipolar Disorders Medicine-Psychiatry and Mental Health
CiteScore
6.70
自引率
5.00%
发文量
26
审稿时长
13 weeks
期刊介绍: The International Journal of Bipolar Disorders is a peer-reviewed, open access online journal published under the SpringerOpen brand. It publishes contributions from the broad range of clinical, psychological and biological research in bipolar disorders. It is the official journal of the ECNP-ENBREC (European Network of Bipolar Research Expert Centres ) Bipolar Disorders Network, the International Group for the study of Lithium Treated Patients (IGSLi) and the Deutsche Gesellschaft für Bipolare Störungen (DGBS) and invites clinicians and researchers from around the globe to submit original research papers, short research communications, reviews, guidelines, case reports and letters to the editor that help to enhance understanding of bipolar disorders.
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