In this study,we examined the point prevalence rate of atypical features in bipolar disorder,and estimated the potential impact of these features on treatment practices in China. Using the atypical features criteria o...In this study,we examined the point prevalence rate of atypical features in bipolar disorder,and estimated the potential impact of these features on treatment practices in China. Using the atypical features criteria of the Diagnostic and Statistical Manual of the American Psychiatric Association（DSM-IV）,we documented the atypical symptoms in 3 906 consecutive participants with bipolar disorder enrolled at 26 psychiatric services across China. We further assessed the association between atypical features and the treatment approaches,including the prescription of antidepressants. The overall point prevalence rate of atypical features was 9.1% among patients with various bipolar disorder subtypes. When the definition was broadened to include atypical features B,the overall rate increased to 11.8%. Interestingly,among patients with the mixed state and remission subtypes,there was a significant difference in the rates of antidepressant medication usage between patients who met and those who did not meet the criteria for atypical features B. These fi ndings indicate a trend of using antidepressants for these two types of patients with atypical features. Further,for both mixed state and remission patients,treatment approaches were related to atypicalfeatures B. Our findings provide evidence to assist clinicians to readily recognize atypical features in bipolar subtypes and can propose treatments based on these diagnoses.展开更多
Major depressive disorder(MDD)is a highly heterogeneous mental disorder,and its complex etiology and unclear mechanism are great obstacles to the diagnosis and treatment of the disease.Studies have shown that abnormal...Major depressive disorder(MDD)is a highly heterogeneous mental disorder,and its complex etiology and unclear mechanism are great obstacles to the diagnosis and treatment of the disease.Studies have shown that abnormal functions of the visual cortex have been reported in MDD patients,and the actions of several antidepressants coincide with improvements in the structure and synaptic functions of the visual cortex.In this review,we critically evaluate current evidence showing the involvement of the malfunctioning visual cortex in the pathophysiology and therapeutic process of depression.In addition,we discuss the molecular mechanisms of visual cortex dysfunction that may underlie the pathogenesis of MDD.Although the precise roles of visual cortex abnormalities in MDD remain uncertain,this undervalued brain region may become a novel area for the treatment of depressed patients.展开更多
基金supported by the Science Fund of Shanghai Jiao Tong University (11XJ21006 and YG2012MS11)the Fund of Science and Technology Commission of Shanghai Municipality,China (134119a6200)+3 种基金the Overseas Talent Project of the Shanghai Health Bureau,China (GWHW201208)the "12th Five-year Plan" of the National Key Technologies R&D Program,China (2012BAI01B04)the National Natural Science Foundation of China (91232719)the National Key Clinical Disciplines at the Shanghai Mental Health Center,China (OMA-MH,2011-873)
文摘In this study,we examined the point prevalence rate of atypical features in bipolar disorder,and estimated the potential impact of these features on treatment practices in China. Using the atypical features criteria of the Diagnostic and Statistical Manual of the American Psychiatric Association（DSM-IV）,we documented the atypical symptoms in 3 906 consecutive participants with bipolar disorder enrolled at 26 psychiatric services across China. We further assessed the association between atypical features and the treatment approaches,including the prescription of antidepressants. The overall point prevalence rate of atypical features was 9.1% among patients with various bipolar disorder subtypes. When the definition was broadened to include atypical features B,the overall rate increased to 11.8%. Interestingly,among patients with the mixed state and remission subtypes,there was a significant difference in the rates of antidepressant medication usage between patients who met and those who did not meet the criteria for atypical features B. These fi ndings indicate a trend of using antidepressants for these two types of patients with atypical features. Further,for both mixed state and remission patients,treatment approaches were related to atypicalfeatures B. Our findings provide evidence to assist clinicians to readily recognize atypical features in bipolar subtypes and can propose treatments based on these diagnoses.
基金This review was supported by grants from the National Natural Science Key Foundation of China(81830040 and 82130042)the China Science and Technology Innovation 2030-Major Project(2022ZD0211701 and 2021ZD0200700)+1 种基金the Science and Technology Program of Guangdong(2018B030334001)the Science and Technology Program of Shenzhen(GJHZ20210705141400002,KCXFZ20211020164543006,JCYJ20220818101615033,and 202206063000055).
文摘Major depressive disorder(MDD)is a highly heterogeneous mental disorder,and its complex etiology and unclear mechanism are great obstacles to the diagnosis and treatment of the disease.Studies have shown that abnormal functions of the visual cortex have been reported in MDD patients,and the actions of several antidepressants coincide with improvements in the structure and synaptic functions of the visual cortex.In this review,we critically evaluate current evidence showing the involvement of the malfunctioning visual cortex in the pathophysiology and therapeutic process of depression.In addition,we discuss the molecular mechanisms of visual cortex dysfunction that may underlie the pathogenesis of MDD.Although the precise roles of visual cortex abnormalities in MDD remain uncertain,this undervalued brain region may become a novel area for the treatment of depressed patients.
