양극성 장애 환자의 첫 삽화에 따른 임상적 특징
Clinical Features Related to First Episode Polarity in Bipolar Disorder
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초록
본 연구는 입원 치료를 받았던 양극성 장애 환자의 임상적 특징을 4개 기관에서 520명이라는 대규모의 연구 대상에 대해 살펴보았다는 점에서 의의가 있다. 본 결과는 양극성 장애의 조증 삽화뿐 아니라 우울 삽화의 양상 및 경과에도 관심을 기울여야 하는 근거를 제시하고 있다. 우울 삽화로 시작하는 양극성 장애의 경우 우울증으로 진단 받는 경우가 많았으며 보다 많은 자살 시도의 과거력을 보였다. 향후 첫 삽화의 종류와 임상 경과와의 상관성에 대한 외래 추적 연구가 필요할 것이다.
Abstract
Objectives: It has been reported that first episode polarity affected the course and the prognosis of bipolar disorder. However, there is remarkable paucity of information regarding first episode polarity in bipolar disorder. We investigated the clinical characteristics related to the first episode polarity of bipolar patients who had been hospitalized. Methods: Analyses were based on the medical documents of 520 bipolar patients who had been hospitalized in 4 hospitals. We examined clinical features of the current episode, demographics, past treatment history, suicidal attempt history, family history, and comorbidity. And clinical characteristics were compared between manic onset and depressive onset patients. Results: The mean age of the patients was 36.7 years old; they had 2.1 admission history and 6.6 years of illness duration. The patients beginning with depressive onset was 39.4%, and they had more diagnosis of bipolar II disorder, more number of suicidal attempts, and reported more depressive mood during index admission than manic onset patients. Conclusion: Depressive onset is common presentation in bipolar disorder. It is necessary to give more attention to depressive episode in bipolar disorder. Prospective study needs to explore the correlation of first-episode of polarity and course of the illness in the future.
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