조증 삽화로 입원했던 환자의 재평가：혼재성 삽화 진단의 가능성

• 영문명: Re-evaluation of Bipolar Patients Hospitalized for Manic Episode： Possibility of Diagnosing as a Mixed Episode
• 발행기관: 대한신경정신의학회
• 저자명: 전덕인 김경란 이은 손상준
• 간행물 정보: 『신경정신의학』제45권 제4호, 337~342쪽, 전체 6쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2006.07.30

영문 초록

Objective：Mixed states are difficult to define precisely and to recognize accurately. Moreover, the DSM-IV criteria for diagnosis of a mixed episode might be too restrictive. The purpose of this study was to investigate the possibility of a mixed episode in bipolar inpatients hospitalized with DSM-IV manic episodes using the Cincinnati criteria, which is a broader criteria compared to DSM-IV. Methods：Inpatient charts of manic patients were carefully evaluated to determine the presence of depressive symptoms in the Cincinnati criteria. The probable mixed patient group was compared with the definitely manic patient group on demographic and clinical variables. The predictability of depressive symptoms for a mixed episode was assessed. Results：Twenty-one out of 101 manic inpatients were possibly diagnosed as mixed episodes. They showed more psychiatric family history, comorbid personality disorder and suicide attempts. Two symptoms (suicidal ideation and helplessness or hopelessness) had good positive predictive value. Conclusion：Diagnosis of a mixed episode can be increased with careful interview and by using a broader diagnostic criteria. The presence of suicidal ideation and helplessness or hopelessness may suggest a mixed state

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키워드

Bipolar disorder Mixed episode Re-evaluation Diagnosis Cincinnati criteria