CAUSES AND TREATMENTS OF RAPID CYCLING AFFECTIVE DISORDERS

快速循环情感障碍的原因和治疗

• 批准号: 3922047
• 负责人: T A WEHR
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3922047
• 关键词: antidepressants; behavioral genetics; bipolar depression depressed phase; circadian rhythms; clinical depression; hormone regulation /control mechanism; human subject; interview; mental disorder chemotherapy; mood disorders; neurochemistry; psychobiology

Affective illness tends to remit and recur spontaneously and with increasing frequency. Its course is also characterized by a tendency for manic episodes to be immediately preceded or followed by depressive episodes, with no intervening normal period, and for mania to alternate with depression. In rapid cycling affective disorder these tendencies are so pronounced that mania and depression recur regularly and frequently with a continuous, circular course. Rapid cycling cases comprise about 15% of patients in lithium or affective disorder clinics, and they are difficult to treat. The purpose of this project was to gain further insights into the causes and treatments of rapid cycling affective disorder by comparing data obtained from rapid cycling and non-rapid cycling patients with regard to their clinical features and course of illness. All rapid cycling patients admitted to our research program since 1973 were included in the study. For comparison, a non-rapid cycling control group was also investigated. Information regarding the patients' psychiatric and medical histories, family histories, cause of illness, and responses to treatments was derived from hospital charts, research flow charts containing records of prospective daily mood ratings, treatments and procedures, and structured follow-up interviews. We found that 1) rapid cycling affective disorder is phenotypically and genetically related to more typical forms of bipolar affective disorder; 2) there was a high prevalence of thyroid disease during lithium treatment in both rapid cycling and non-rapid cycling women; 3) although nearly all the rapid cycling patients were women, there was no convincing evidence that the rapid cycles were generated by the menstrual cycle; 4) treatment with antidepressant drugs was associated with reversible rapid cycling in approximately 50% of the rapid cycling patients; patients experienced sowing or cessation of cycling when the drugs were withdrawn. The observation that antidepressants may have been responsible for rapid cycling in half the cases has obvious implications for prevention and treatment of rapid cycling, and it provides a clue to possible neurochemical causes of rapid cycling.

情感疾病倾向于自发地汇聚和复发 频率增加。 它的课程也以 紧接或遵循的躁狂发作的趋势 通过抑郁发作，没有中间的正常时期，也没有 躁狂症交替抑郁。 在快速骑自行车的情感中 这些趋势是如此明显，以至于躁狂和 抑郁症经常频繁地反复出现，连续， 圆形路线。 快速骑自行车案件约占15％ 锂或情感障碍诊所的患者，他们是 很难治疗。 这个项目的目的是获得 进一步了解快速骑自行车的原因和处理 通过比较快速循环获得的数据，情感障碍 和非比骑自行车患者的临床 特征和病程。 所有快速骑自行车的患者 自1973年以来接受了我们的研究计划的承认 学习。 为了进行比较，也是一个非拉比骑自行车对照组 调查。 有关患者精神病和 病史，家庭历史，疾病原因和 对治疗的反应来自医院图表，研究 流程图包含预期日常情绪评级的记录， 治疗和程序以及结构化的后续访谈。 我们发现1）快速循环情感障碍是表型 并与更典型的双极情感形式有关 紊乱; 2）甲状腺疾病的患病率很高 快速骑自行车和非比循环中的锂处理 女性; 3）尽管几乎所有快速骑自行车患者都是 妇女，没有令人信服的证据表明快速周期是 由月经周期产生； 4）用抗抑郁药治疗 药物大约与可逆快速循环有关 50％的快速骑自行车患者；患者经历了播种或 撤离药物时停止骑自行车。 这 观察抗抑郁药可能是负责的 一半案件的快速骑自行车对 预防和治疗快速骑自行车，并提供了线索 可能导致快速循环的神经化学原因。