摘要
目的 了解双相抑郁治疗过程出现转相的危险因素。方法 对150例接受抗抑郁药物治疗的病人进行相关因素调查,比较转躁与未转躁患者的有关因素,并回归分析这些相关因素。结果 在150例双相障碍中,由抗抑郁药物引发的转躁例数41例,转躁率34%。单因素分析发现,小于等于25岁发病（P〈0.01）、总病程长[（3.83±3.88）年,（7.00±7.56）年,P〈0.01]、个性外向（P〈0.01）、有双相障碍家族史（P〈0.01）、病情比较严重（40/1,80/29,X^2=9.41,P〈0.01）、以及使用三环类抗抑郁药物（TCA,33/8,54/55,X^2=11.71,P〈0.01）、两种抗抑郁药物联合应用（19/22,30/89,X^2=12.13,P〈0.01）不联合碳酸锂（4/37,38/71,X^2=9.31,P〈0.01）、过去有过类似病史（19/22,9/100,X^2=28.46,P〈0.01）、过去自然转躁次数多、第一次以抑郁发作等因素与抗抑郁治疗导致转相有关。回归分析提示双相障碍家族史、联合抗抑郁药物治疗、以抑郁为首发症状、外向个性特征、使用三环类抗抑郁药物（TCA）起重要作用。结论 抗抑郁药物治疗双相抑郁的转相有危险因素相伴,注意识别与预防。
Objective To explore the risks associated with switching during treatment with antidepressants in patients with bipolar depression. Methods 150 cases with bipolar depression treated with antidepressants were investigated in relative factors, which were analyzed by single comparison and muhifactor regression. Results The switching rate of 150 patients with bipolar disorders is 34%. The factors of younger than 25 years old （22/19, 27/82, X^2 = 11.30, P 〈 0.01 ） ,longer duration of disease （ 3.83± 3.88,7.00 ± 7.56, t = 2.55, P〈 0.01 ） , extrovert personality（ 24/17,36/73, X^2 = 8.08, P 〈 0.01 ）, family history of bipolar disorder（ 8/33,6/103, X^2 = 6.94, P〈0.01 ）, more severe episode （ 19/22,30/89, X^2 = 12. 13, P 〈 0.01 ） , usage of TCA （ 33/8,54/55, X^2 = 11.71, P 〈 0.01 ）, no combination of lithium carbonate, combination of two antidepressants, past similar history （ P 〈 0.01 ） , more times of past switching mania,first episode of depression other than mania were found associated with switching during therapy by single factor analysis. The regression also indicated that family history of bipolar disorder, combination of antidepressants, first episode of depression,extrovert personality, using of TCA were risk of switching during antidepressant therapy in bipolar depression. Conclusion The switching to manic during therapy of antidepressants for bipolar depression were associated with some risk factors, which was useful in identification and prevention.
出处
《中国行为医学科学》
CSCD
2007年第5期416-417,共2页
Chinese Journal of Behavioral Medical Science
基金
浙江省卫生厅医药科研基金资助项目（2006A017）
