门诊双相情感障碍临床现象学分析

Clinical features and pharmacotherapy of bipolar disorder

目的了解门诊双相情感障碍(BPD)患者的临床特征和药物治疗方式。方法采用自编的调查问卷对符合DSM-IV双相情感障碍诊断标准的门诊患者进行研究。结果①入组患者共203例,其中双相I型163例(80.3%),双相Ⅱ型40例(19.7%)。②最主要的治疗药物为心境稳定剂(70.4%),其次为抗精神病药物(63%)。③Ⅰ型患者使用心境稳定剂者、抗精神病药物及苯二氮类药物者多于Ⅱ型患者;Ⅱ型患者使用抗抑郁药多于Ⅰ型患者。④联合2种及以上药物治疗者占72.4%。⑤80.5%的双相情感障碍患者病情处于稳定状态。结论门诊双相情感障碍双相I型多于Ⅱ型,Ⅱ型更容易漏诊。目前临床门诊药物治疗方式与国内外指南推荐方案基本符合,联合用药多,多数患者治疗效果良好。

Objective To explore the clinical features and pharmacotherapy of outpatients with bipolar disorder.Methods Outpatients with bipolar disorder according to DSM-IV were included and were assessed with self-made questionnaires.Results ① Two hundred and three cases of patients were enrolled.Among which 163 cases（80.3%）were diagnosed as bipolar disorder Ⅰ and 40 cases（19.7%）bipolar disorder Ⅱ.② The most important medicine was mood-stabilizations（70.4%）and the second antipsychotic（63%）.③ More cases with bipolar disorder Ⅰ were treated with mood-stabilizations,antipsychotic and benzodiazepines than ones with bipolar disorder Ⅱ.While more cases with bipolar disorder Ⅱ were treated with antidepressants than ones with bipolar disorder Ⅰ were.④ 72.4% patients were receiving two or more than two kinds of drugs.⑤80.5% bipolar disorder patients were in stable condition.Conclusion There were more outpatients with bipolar disorder Ⅰ than ones with bipolar disorder Ⅱ.Patients with bipolar disorder Ⅱ were easy to be missed.The present medications have been already accommodated with the guidelines of pharmacotherapy in bipolar disorder both in China and abroad.Many patients were receiving more than one drug.Most patients received good effects.