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Undiagnosed bipolar disorder in patients treated for major depression in China
Hu, Chen2; Xiang, Yu-Tao1; Ungvari, Gabor S.3; Dickerson, Faith B.4; Kilbourne, Amy M.5,6; Si, Tian-Mei7; Fang, Yi-Ru8; Lu, Zheng9; Yang, Hai-Chen10; Chiu, Helen F. K.1; Lai, Kelly Y. C.1; Hu, Jian11; Chen, Zhi-Yu12; Huang, Yi13; Sun, Jing14; Wang, Xiao-Ping15; Li, Hui-Chun16; Zhang, Jin-Bei17; Wang, Gang2
关键词Bipolar Disorder Major Depressive Disorder Screening Diagnostic Criteria
刊名JOURNAL OF AFFECTIVE DISORDERS
2012-10-01
DOI10.1016/j.jad.2012.02.014
140期:2页:181-186
收录类别SCI ; SSCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Clinical Neurology ; Psychiatry
研究领域[WOS]Neurosciences & Neurology ; Psychiatry
关键词[WOS]INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW ; II DISORDER ; MOOD DISORDERS ; DSM-IV ; UNIPOLAR ; HCL-32 ; QUESTIONNAIRE ; OUTPATIENTS ; VALIDATION ; HYPOMANIA
英文摘要

Background: Bipolar disorder (BD) is a recurrent, complex illness and often misdiagnosed and treated as a major depressive disorder (MDD). This study set out (1) to investigate the proportion of BD in patients treated for MDD using DSM-IV diagnostic criteria; (2) to test the usefulness of the screening tool the - 32-item Hypomania Checklist (HCL-32) in Chinese patients; and (3) to assess whether MDD patients with subthreshold manic features (patients who screened positive for BD on the HCL-32, but did not meet the diagnostic criteria for DSM-IV BD as measured by Mini International Neuropsychiatric Interview (MINI)) differ from those with BD, and from those suffering from MDD without manic features in terms of basic demographic and clinical variables.

Methods: A total of 1487 patients treated for MDD were consecutively examined in 13 mental health centers in China. The patients′ socio-demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The HCL-32 was self-completed by patients to identify hypomanic symptoms, and the MINI was used by clinicians to establish DSM-IV diagnoses.

Results: The proportions of undiagnosed BD (all types), BD-I and BD-II were 20.8%, 7.9% and 12.8%, respectively. The HCL-32 had low positive predictive value (0.43). Compared to MDD patients without subthreshold manic features, MDD patients with subthreshold manic features were younger at onset, less likely to be married and had more depressive episodes on a seasonal basis, and more frequent depressive episodes overall. Compared to BD patients, MDD patients with subthreshold manic features had an older age at onset and less frequent depressive episodes and less family history of psychiatric disorders, appetite, weight gain and time spent sleeping, suicide ideation and attempts and psychotic symptoms.

Conclusions: At least one fifth of Chinese patients treated for MDD may have an undiagnosed BD. The HCL-32 is useful to identify broader subthreshold bipolar features. The findings need to be confirmed by longitudinal studies using more comprehensive, standardized instruments. (C) 2012 Elsevier B.V. All rights reserved.

语种英语
WOS记录号WOS:000306456400009
项目编号2007BAI17B05
资助机构Ministry of Science and Technology of China ; AstraZeneca China
引用统计
被引频次:16[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55572
专题北京大学精神卫生研究所
作者单位1.Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China
2.Sheppard Pratt, Stanley Res Program, Baltimore, MD USA
3.Vet Adm Ann Arbor Ctr Clin Management Res, Ann Arbor, MI USA
4.Chinese Univ Hong Kong, Dept Psychiat, Hong Kong, Hong Kong, Peoples R China
5.Capital Med Univ, Beijing Anding Hosp, Mood Disorders Ctr, Beijing, Peoples R China
6.Univ Notre Dame Australia, Marian Ctr, Perth, WA, Australia
7.Univ Michigan, Sch Med, Dept Psychiat, Ann Arbor, MI USA
8.Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Div Mood Disorders, Shanghai 200030, Peoples R China
9.Tongji Univ, Sch Med, Shanghai Tongji Hosp, Shanghai 200092, Peoples R China
10.Shenzhen Mental Hlth Ctr, Div Mood Disorders, Shenzhen, Guangdong, Peoples R China
11.Harbin Med Univ, Hosp 1, Harbin, Heilongjiang Pr, Peoples R China
12.Hangzhou Seventh Peoples Hosp, Hangzhou, Zhejiang, Peoples R China
13.Sichuan Univ, W 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, Zhejiang, Peoples R China
17.Sun Yat Sen Univ, Affiliated Hosp 3, Guangzhou, Guangdong, Peoples R China
推荐引用方式
GB/T 7714
Hu, Chen,Xiang, Yu-Tao,Ungvari, Gabor S.,et al. Undiagnosed bipolar disorder in patients treated for major depression in China[J]. JOURNAL OF AFFECTIVE DISORDERS,2012,140(2):181-186.
APA Hu, Chen.,Xiang, Yu-Tao.,Ungvari, Gabor S..,Dickerson, Faith B..,Kilbourne, Amy M..,...&Wang, Gang.(2012).Undiagnosed bipolar disorder in patients treated for major depression in China.JOURNAL OF AFFECTIVE DISORDERS,140(2),181-186.
MLA Hu, Chen,et al."Undiagnosed bipolar disorder in patients treated for major depression in China".JOURNAL OF AFFECTIVE DISORDERS 140.2(2012):181-186.
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