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学科主题: 精神卫生
题名:
Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China
作者: Xiang, Yu-Tao1,2; Zhang, Ling1; Wang, Gang1; Hu, Chen1; Ungvari, Gabor S.3; Dickerson, Faith B.4; Kilbourne, Amy M.5,6; Si, Tian-Mei7; Fang, Yi-Ru8; Lu, Zheng9; Yang, Hai-Chen10; Lai, Kelly Y. C.2; Lee, Edwin H. M.2; Hu, Jian11; Chen, Zhi-Yu12; Huang, Yi13; Sun, Jing14; Wang, Xiao-Ping15; Li, Hui-Chun16; Zhang, Jin-Bei17; Chiu, Helen F. K.2
关键词: bipolar disorder ; diagnosis ; major depressive disorder
刊名: BIPOLAR DISORDERS
发表日期: 2013-03-01
DOI: 10.1111/bdi.12052
卷: 15, 期:2, 页:199-205
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Neurosciences ; Psychiatry
研究领域[WOS]: Neurosciences & Neurology ; Psychiatry
关键词[WOS]: MOOD DISORDERS ; MORTALITY ; POLARITY ; ONSET ; AGE
英文摘要:

Objectives Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China. Methods A total of 1487 patients diagnosed with MDD were consecutively evaluated in 13 psychiatric hospitals or psychiatric units of general hospitals nationwide in China. The patients′ sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini-International Neuropsychiatric Interview (MINI) was used to establish DSM-IV diagnoses, and identify patients with MDD and those with BD, but being misdiagnosed with MDD. Results The proportions of BD (all types), bipolar I disorder (BD-I), and bipolar II disorder (BD-II) misdiagnosed as MDD in clinical practice were 20.8%, 7.9%, and 12.8%, respectively. Multiple logistic regression analyses revealed that compared to MDD patients, BD-I was characterized by more atypical depressive features (increased appetite, increased sleep, and weight gain) [odds ratio (OR)=2.0, 95% confidence interval (CI): 1.23.2], more psychotic symptoms (OR=2.1, 95% CI: 1.33.5), more lifetime depressive episodes (OR=1.1, 95% CI: 1.11.2), and earlier age of onset (OR=0.97, 95% CI: 0.90.99); BD-II was characterized by more psychotic symptoms (OR=2.1, 95% CI: 1.43.1) and earlier age of onset (OR=0.96, 95% CI: 0.90.97). In addition, compared to BD-II patients, BD-I patients were characterized by more frequent depressive episodes per year (OR=3.1, 95% CI: 1.56.6). Conclusions Depressive episodes in the context of BD-I and BD-II, among those who were misclassified as MDD, present some different clinical features compared to MDD. This finding should be taken into account in guiding diagnostic practices in China.

语种: 英语
所属项目编号: 2007BAI17B05
项目资助者: Ministry of Science and Technology of China ; AstraZeneca China
WOS记录号: WOS:000315414100009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/52283
Appears in Collections:北京大学精神卫生研究所_期刊论文

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作者单位: 1.Sheppard Pratt, Stanley Res Program, Baltimore, MD USA
2.Vet Adm Ann Arbor Ctr Clin Management Res, Ann Arbor, MI USA
3.Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China
4.Hangzhou Seventh Peoples Hosp, Hangzhou, Zhejiang, Peoples R China
5.Capital Med Univ, Beijing Anding Hosp, Mood Disorders Ctr, Beijing, Peoples R China
6.Chinese Univ Hong Kong, Dept Psychiat, Hong Kong, Hong Kong, Peoples R China
7.Univ Notre Dame Australia, Marian Ctr, Perth, WA, Australia
8.Univ Michigan, Sch Med, Dept Psychiat, Ann Arbor, MI 48109 USA
9.Shanghai Jiao Tong Univ, Sch Med, Div Mood Disorders, Shanghai Mental Hlth Ctr, Shanghai 200030, Peoples R China
10.Tongji Univ, Shanghai Tongji Hosp, Sch Med, Shanghai 200092, Peoples R China
11.Shenzhen Mental Hlth Ctr, Div Mood Disorders, Shenzhen, Guangdong, Peoples R China
12.Harbin Med Univ, Hosp 1, Harbin, Heilongjiang Pr, Peoples R China
13.Sichuan Univ, West China Hosp, Chengdu, Sichuan Provinc, Peoples R China
14.Nanjing Med Univ, Affiliated Brain Hosp, Nanjing, Jiangsu, Peoples R China
15.Cent S Univ, Xiangya Hosp 2, Mental Hlth Inst, Changsha, Hunan, Peoples R China
16.Zhejiang Univ, Coll Med, Affiliated Hosp 2, Hangzhou 310003, Zhejiang, Peoples R China
17.Sun Yat Sen Univ, Affiliated Hosp 3, Guangzhou 510275, Guangdong, Peoples R China

Recommended Citation:
Xiang, Yu-Tao,Zhang, Ling,Wang, Gang,et al. Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China[J]. BIPOLAR DISORDERS,2013,15(2):199-205.
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