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双相障碍
Bipolar Disorder


Andre F. Carvalho ... 其他 • 2020.07.02
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在日常生活中,因令人紧张或愉悦的事件而发生情绪波动的情况常见。而导致心理困扰和行为障碍的严重且持久的情绪波动则可能是情感障碍的症状。情感障碍是一个疾病谱系,其分类从单相抑郁至双相Ⅱ型障碍和双相Ⅰ型障碍1

19世纪50年代,Falret将双相障碍描述为一种独立的疾病2。《精神疾病诊断与统计手册》第五版(DSM-5)将“双相障碍和相关障碍”列为一类疾病,包括双相Ⅱ型障碍、双相Ⅰ型障碍和循环性精神障碍。不符合典型亚型的非典型双相障碍被包括在“其他特定的双相障碍和双相相关障碍”类别中3。最近发布的《国际疾病分类》修订版11(ICD-11)也包括了关于双相障碍的章节4

双相障碍不同于其他情感障碍的主要特征是反复发生躁狂或轻躁狂发作,而且可能与抑郁发作交替出现。双相Ⅰ型障碍的定义是出现明显的躁狂发作,并有过度自信、自大、健谈、极度脱抑制、易激惹、睡眠需求减少和情绪明显高涨等一系列表现。在躁狂发作中,妄想和幻觉等精神病症状的发生率高达75%,而任何严重程度的发作都可能损害患者的心理社会功能,以致需要住院治疗。双相Ⅱ型障碍的主要特征是抑郁发作,但与轻躁狂而不是躁狂交替出现。如果一生中有过至少一次轻躁狂发作,则认为其与双相Ⅱ型障碍的诊断相吻合。循环性精神障碍的特征是反复出现抑郁和轻躁狂状态,持续至少2年,并且未达到重性情感发作的诊断标准。





作者信息

Andre F. Carvalho, M.D., Ph.D., Joseph Firth, Ph.D., and Eduard Vieta, M.D., Ph.D.
From the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto (A.F.C.); the IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC (A.F.C.), and the NICM Health Research Institute, Western Sydney University, Westmead, NSW (J.F.) — both in Australia; the Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, United Kingdom (J.F.); and the Psychiatry and Psychology Department of the Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS (August Pi i Sunyer Biomedical Research Institute), and CIBERSAM (Biomedical Research Networking Center for Mental Health Network), Barcelona (E.V.). Address reprint requests to Dr. Carvalho at the Centre for Addiction and Mental Health, Bell Gateway Bldg. 100 Stokes St., 4th Fl., Toronto ON M6J 1H4, Canada, or at andrefc7@hotmail.com.

 

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