The clinical phenotype of bipolar disorder patients with depression as the first episode
10.3760/cma.j.cn113661-20200331-00155
- VernacularTitle:以抑郁为首次发作的双相障碍临床表型分析
- Author:
Guoqing ZHAO
1
;
Yousong SU
;
Chen ZHANG
;
Daihui PENG
;
Zuowei WANG
;
Jia HUANG
;
Yong WANG
;
Rubai ZHOU
;
Fan WANG
;
Wu HONG
;
Jun CHEN
;
Yiru FANG
Author Information
1. 上海交通大学医学院附属精神卫生中心心境障碍科 200030
- Publication Type:Journal Article
- Keywords:
Bipolar disorder;
Depression;
Mania
- From:
Chinese Journal of Psychiatry
2020;53(6):473-478
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of bipolar disorder patients who present with depressive symptoms at their first episode.Methods:A total of 1 600 bipolar disorder patients with the first episode of depression who participated in the clinical pathway survey of bipolar disorder were included in this study. Demographic data, clinical phenotype, and symptomatic characteristics when they presented with their first mania were described. One-way analysis of variance was applied to compare the clinical characteristics between patients who visited the general hospitals and the ones who visited the mental health centers, and chi-square test was applied to compare symptomatology of patients at the first hypomania/mania episode and their mania relapse.Results:The average time from the first depressive episode to the first hypomanic/manic episode was 3.63 years. It took an average of 1.83 years from the first hypomanic/manic episode to the diagnosis of bipolar mania, and only 45.4% (728 cases) were diagnosed as bipolar disorder when they presented with depression at their first episode; It was an average of 5.45 years from the first depressive episode to the diagnosis of bipolar disorder; There were statistically significant differences in the number of previous depressive episodes ( F=7.119, P=0.008) and the total number of previous episodes ( F=3.980, P=0.046) between bipolar disorder patients seen in the mental health centres and general hospitals. The top three symptoms of the first manic episode were mood elation (83%, 215 cases); increased activity (81.5%, 211 cases); increased speech (79.9%, 207 cases). Compared with recurrent manic episodes, patients at their first manic episode were more likely to report more gregarious (χ2=13.277, P<0.01), eloquent/humorous (χ2=10.665, P=0.001), and less likely to report excessive use of psychoactive substances (χ2=3.990, P=0.046). Conclusions:It takes a long time for the diagnosis of bipolar disorder who presents with the depressive mood in their first episode. The first manic episode is not easy to identify, and the patients treated in general hospitals have more frequent depressive episodes, while the first manic episode shows some different symptoms from the recurrent manic episodes.
