雙極性病譜疾患

雙極性病譜疾患乃一發展中的診斷概念，此一疾患的範圍包括由躁症發作的這一極到單極性憂鬱症的另一極，終生盛行率比傳統的雙極性疾患要高，約計達5%。臨床症狀包括輕躁發作、躁症發作、混合狀態、抗憂鬱劑誘發輕躁、憂鬱症合併高昂性格及復發性重鬱症合併雙極性家族史等。由於雙極性疾患的輕躁發作不易被發覺，患者大多在憂鬱期才來就醫，使臨床醫師容易誤診為單極性重鬱症，單獨使用抗憂鬱劑的結果，不但臨床症狀無法改善，反有可能使患者出現輕躁、躁症、快速循環或混合狀態，增加患者痛苦、拖延病程、加重憂鬱、甚或自殺。因此，臨床醫師在診治憂鬱症患者時，需要考慮是否有雙極性病譜疾患的可能性；一旦發現，必須積極使用情緒穩定劑。

關鍵字

雙極性病譜疾患；雙極性疾患；混合狀態；高昂型性格

並列摘要

Bipolar spectrum disorder is still an evolving concept. The prevalence of this disorder is significantly higher than previously believed and may approach rates as high as 5%. This disorder is a longitudinal diagnosis and its clinical symptoms include hypomania, mania, mixed states, major depressive episode, hyperthymic temperament and depressive mixed state. Since bipolar patients are likely to seek treatment for their depression rather for their hypomania or mania, clinician should consider the possibility of bipolar spectrum disorder for all patients presenting for treatment of major depression. A history of hypomania or mania must be taken into consideration by the clinician when initializing a treatment plan. It is recommended that treatment for bipolar depression should include mood stabilizers and add, as required, antidepressants or newer mood stabilizers. Antidepressant monotherapy could push patients' mood to hypomania, mania, rapid cycling or mixed state.

並列關鍵字

bipolar spectrum disorder ； bipolar disorder ； mixed state ； hyperthymic temperament

參考文獻

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