BMJ Open:抗抑郁治疗时应警惕躁狂症的发生

2015-12-17 MedSci MedSci原创

本研究旨在探讨抗抑郁药治疗与日后躁狂症/双相情感障碍发生之间的关系。

本研究旨在探讨抗抑郁药治疗与日后躁狂症/双相情感障碍发生之间的关系。

采用回顾性队列研究,共纳入了21012名单相抑郁症成人患者。根据其电子病历记录所有研究对象的抗抑郁治疗情况。时间为从诊断为从诊断为单相抑郁症至随后诊断为躁狂症或双相情感障碍。使用多变量Cox回归分析数据,以年龄和性别作为协变量。

结果发现,躁狂症/双相情感障碍的总发病率为10.9/1000人年。躁狂症/双相情感障碍发生高峰年龄在26-35岁之间(12.3/1000人年)。既往抗抑郁治疗与日后躁狂症/双相情感障碍发病率的增加有关,从13.1/1000人年增加至19.1/1000人年。多变量分析表明,选择性5-羟色胺再摄取抑制剂(HR=1.34,95% CI 1.18-1.52)及文拉法辛(HR=1.35,95% CI 1.07-1.70)的使用与日后躁狂症/双相情感障碍的发生明显相关。

总而言之,本研究表明,抑郁症患者接受抗抑郁治疗与日后躁狂症/双相情感障碍的发生风险增加有关。这些研究结果强调了抑郁症患者在接受抑郁治疗时考虑躁狂症发生危险因素的重要性。

原始出处:

Rashmi Patel, Peter Reiss1 et al.Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study. BMJ Open 2015;5:e008341 doi:10.1136/bmjopen-2015-008341

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1951518, encodeId=910d195151888, content=<a href='/topic/show?id=64ef5533e0d' target=_blank style='color:#2F92EE;'>#抗抑郁治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55337, encryptionId=64ef5533e0d, topicName=抗抑郁治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Fri Feb 05 20:55:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847813, encodeId=efd0184e81346, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Sep 24 23:55:00 CST 2016, time=2016-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705730, encodeId=9a821e05730a5, content=<a href='/topic/show?id=380f931834c' target=_blank style='color:#2F92EE;'>#躁狂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93183, encryptionId=380f931834c, topicName=躁狂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c31043182, createdName=wgx316, createdTime=Fri Dec 18 17:55:00 CST 2015, time=2015-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725964, encodeId=fff51e2596439, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Wed Jul 27 02:55:00 CST 2016, time=2016-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48272, encodeId=7deb482e295, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:14:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=47121, encodeId=ff384e121ca, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Tue Dec 22 17:47:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492144, encodeId=edf11492144dc, content=<a href='/topic/show?id=7999553333c' target=_blank style='color:#2F92EE;'>#抗抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55333, encryptionId=7999553333c, topicName=抗抑郁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a59b8920619, createdName=wushaoling, createdTime=Sat Dec 19 10:55:00 CST 2015, time=2015-12-19, status=1, ipAttribution=)]
    2016-09-24 仁者大医
  3. [GetPortalCommentsPageByObjectIdResponse(id=1951518, encodeId=910d195151888, content=<a href='/topic/show?id=64ef5533e0d' target=_blank style='color:#2F92EE;'>#抗抑郁治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55337, encryptionId=64ef5533e0d, topicName=抗抑郁治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Fri Feb 05 20:55:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847813, encodeId=efd0184e81346, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Sep 24 23:55:00 CST 2016, time=2016-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705730, encodeId=9a821e05730a5, content=<a href='/topic/show?id=380f931834c' target=_blank style='color:#2F92EE;'>#躁狂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93183, encryptionId=380f931834c, topicName=躁狂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c31043182, createdName=wgx316, createdTime=Fri Dec 18 17:55:00 CST 2015, time=2015-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725964, encodeId=fff51e2596439, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Wed Jul 27 02:55:00 CST 2016, time=2016-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48272, encodeId=7deb482e295, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:14:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=47121, encodeId=ff384e121ca, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Tue Dec 22 17:47:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492144, encodeId=edf11492144dc, content=<a href='/topic/show?id=7999553333c' target=_blank style='color:#2F92EE;'>#抗抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55333, encryptionId=7999553333c, topicName=抗抑郁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a59b8920619, createdName=wushaoling, createdTime=Sat Dec 19 10:55:00 CST 2015, time=2015-12-19, status=1, ipAttribution=)]
    2015-12-18 wgx316
  4. [GetPortalCommentsPageByObjectIdResponse(id=1951518, encodeId=910d195151888, content=<a href='/topic/show?id=64ef5533e0d' target=_blank style='color:#2F92EE;'>#抗抑郁治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55337, encryptionId=64ef5533e0d, topicName=抗抑郁治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c3a189, createdName=longqijun248, createdTime=Fri Feb 05 20:55:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847813, encodeId=efd0184e81346, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Sat Sep 24 23:55:00 CST 2016, time=2016-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1705730, encodeId=9a821e05730a5, content=<a href='/topic/show?id=380f931834c' target=_blank style='color:#2F92EE;'>#躁狂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93183, encryptionId=380f931834c, topicName=躁狂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c31043182, createdName=wgx316, createdTime=Fri Dec 18 17:55:00 CST 2015, time=2015-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725964, encodeId=fff51e2596439, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Wed Jul 27 02:55:00 CST 2016, time=2016-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48272, encodeId=7deb482e295, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 16:14:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=47121, encodeId=ff384e121ca, content=过犹不及, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Tue Dec 22 17:47:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492144, encodeId=edf11492144dc, content=<a href='/topic/show?id=7999553333c' target=_blank style='color:#2F92EE;'>#抗抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55333, encryptionId=7999553333c, topicName=抗抑郁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a59b8920619, createdName=wushaoling, createdTime=Sat Dec 19 10:55:00 CST 2015, time=2015-12-19, status=1, ipAttribution=)]
    2016-07-27 feather89
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    2015-12-26 hixiaoluo

    好文章,值得看。

    0

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    2015-12-22 xiaotaiyang1

    过犹不及

    0

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