软双相障碍发展为双相障碍1例

摘要

An old people was diagnosed as depression by attending doctor after admission because of repeated depressive episode and lack of past typical mania and hypomania manifestations ,but he was considered as depressive episode of soft bipolar disorder (SBD) higher-level doctor according to his positive family history of affective disorder and hyperthymia type temperament. He showed hy-pomania manifestations soon after admission ,was diagnosed as bipolar Ⅱ disorder ,and correctness of SBD consideration at that time confirmed. Clinical underdiagnosis of bipolar Ⅱ disorder is easily misdiagnosed as unipolar depression. SBD depressive episode should be treated in terms of bipolar disorder treatment , mood-stabiliziers are used as basic treatment ,and applications of antidepressant drugs should be careful.%老年反复抑郁发作1例，因既往无典型躁狂或轻躁狂表现，入院后经治医生诊断为抑郁症，但结合其有情感性精神障碍阳性家族史，且具有情感旺盛型气质，上级医生考虑为软双相障碍抑郁发作。患者住院不久即出现轻躁狂表现，确诊为双相Ⅱ型障碍，证实了当时考虑软双相抑郁的正确性。临床上双相Ⅱ型障碍的诊断不足，容易误诊为单相抑郁。对于软双相障碍的抑郁发作，需要按照双相抑郁障碍进行治疗，以心境稳定剂作为基础治疗，慎用抗抑郁药物。