在初级保健实践中对双极性障碍的查.
Amar K Das1, Mark Olfson, Marc J Gameroff
1Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York 10032, USA.
JAMA
|February 25, 2005
概括
双极性障碍在初级保健中很常见,但经常被忽视. 早期查和医生教育对于准确的诊断和治疗至关重要,以防止误诊,特别是抑郁症.
科学领域:
- 精神病学是一个精神病学.
- 初级医疗保健医学 一级医疗保健医学
- 心理健康查 心理健康查
背景情况:
- 双极性障碍涉及躁狂和抑郁的情节.
- 仅仅对抑郁症的查可以在初级保健中误诊双相情感障碍.
研究的目的:
- 在成年初级保健患者中查双相情感障碍.
- 检查其临床表现和对功能的影响.
主要方法:
- 1157名成年初级保健患者 (18-70岁) 的系统样本.
- 使用了情绪障碍问卷,PRIME-MD,SF-12,Sheehan残疾量表和医疗记录审查.
- 从2001年12月到2003年1月在一个城市低收入诊所收集的数据.
主要成果:
- 阳性双相情感障碍查的患病率为9.8%,没有显著的人口差异.
- 只有8.4%的阳性选结果被诊断为双相情感障碍,尽管他们寻求帮助.
- 查阳性患者报告生活质量降低,功能障碍增加.
结论:
- 双极性障碍在城市初级保健中是常见的,显著的和未被认可的.
- 医生对查,管理和药物治疗的教育是必不可少的.
- 避免抗抑郁药单一治疗,因为双相情感障碍患者的风险.
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