伴有紧张性症状的女性双相情感障碍的临床研究

摘要

Objective To explore the clinical characters of women bipolar disorder accompanied by symptoms of tension.Methods Patients admitted with symptoms of tension characteristics as the research object,according to the discharge of ICD-10,people were divided into bipolar disorder and catatonic schizophrenia groups.Results There were 30 patients in each group,aged (34.5 ±8.8) and(33.3 ± 7.7) years,disease stage(17.4 ± 12.7) and(38.7 ± 19.3)days(P ＜ 0.01),admission and discharge diagnosis coincidence rate were 66.7％ and 96.7％ (P ＜ 0.01).Comparison of clinical phenomenon showed the bipolar disorder group had sudden onset,more affected by stress factors,premorbid also showed the hypomanic personality characteristics.When the symptoms of tension appeased,there were more such as reflect packing,situation kind of affectation of sexual behavior.The responses to treatment were sensitive than schizophrenia group,and more remission in 1 week.As the relief of symptoms,the BPRS assessment of the bipolar disorder group showed higher scores in anxiety,depression and activate factors (P ＜ 0.05 ～ 0.01).Conclusion As a common acute syndrome in psyehotropic,symptoms of tension often associated with bipolar disorder and schizophrenia.But there are different both in the form of onset,stress influence,personality traits and response to treatment.And with the symptoms of tension remission,bipolar disorder is more likely to reflect the anxiety and depression or excitement characteristics,and schizophrenia lasting thought disorder,hostile suspicion,lack of vitality distinguish somewhat.%目的 探讨伴有紧张性症状的女性双相情感障碍的临床特点.方法 以入院时具有紧张性症状特点,出院时符合ICD-10的双相情感障碍和紧张型精神分裂症进行比较.结果 2组各30例,年龄(34.5±8.8)岁和(33.3±7.7)岁,病期(17.4±12.7)d和(38.7±19.3)d(P＜0.01),入出院诊断符合率为66.7％和96.7％(P＜0.01).临床现象比较中,双相障碍组起病急骤,多受应激因素影响,病前也反映出轻躁狂性格特点.出现紧张性症状时,多反映出“装相”、“作态”样的戏剧化行为,治疗反应较精神分裂症敏感,且多在1周内缓解.随症状缓解后,双相障碍组的BPRS评定显示“焦虑忧郁”、“激活性”因子分值较高(P均＜0.05 ～0.01).结论 紧张性症状作为精神科常见的急性综合征,往往与双相情感障碍和精神分裂症有关.但二者在起病形式、应激影响、性格特点、治疗反应性方面均有所不同.随紧张性症状缓解后,双相情感障碍更多反映出焦虑抑郁或兴奋的情绪化特点,与精神分裂症持久的“思维障碍”、“敌对猜疑”、“缺乏活力”有所区别.