주요우울장애 환자에서 기분장애 질문지를 이용한 양극성 스펙트럼장애 선별에 관한 연구

Abstract

OBJECTIVES: This study was performed to evaluate the frequency of bipolar spectrum disorder (BSD) among patients who have been diagnosed with major depressive disorder. In addition, authors assessed the practical usefulness of the Mood Disorder Questionnaire (MDQ) to investigate the frequency of bipolar spectrum disorder in major depressive disorder. METHODS: The participants were 70 depressive patients who have never been diagnosed with bipolar disorders. The subjects were interviewed for diagnosis using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision criteria and the Mini-International Neuropsychiatric Interview to exclude bipolar disorders from the subjects. BSD criteria (as defined by Ghaemi, et al. 2002), and Korean version of the Mood Disorder Questionnaire (K-MDQ) was used to investigate their bipolarity. Data were collected including family history of affective disorder, number of previous depressive episode, age of onset, history of suicide attempt, comorbid psychiatric illness, and drug and alcohol use. RESULTS: Among 70 subjects, 25 patients (35.7%) were classified as having bipolar spectrum disorder on BSD criteria, while other 45 patients (64.3%) as unipolar depression. Among the 25 patients who meet the BSD criteria, 24 patients (34.3%) scored more than 7 and only 1 patient (1.4%) scored less than 6 on K-MDQ. Among the 45 patients who don't meet BSD criteria, 40 patients (57.1%) scored less than 6 and only 5 patients (7.1%) scored more than 7 on K-MDQ. Early age of onset, recurrent depressive episode, brief depressive episode, bipolar family history, history of suicide attempt, antidepressant induced hypomania, hyperthymic temperament, atypical depressive symptom, psychotic depressive symptom, and antidepressant wear off" were found to be highly related with MDQ positive subjects and BSD subjects among the depressive subjects. CONCLUSION: The result of this study demonstrates the high frequency of BSD in depressive patients who have never been diagnosed with bipolar disorders. Some BSD criteria can be used to differentiate BSD subjects from the subjects with major depressive disorder. Also these results indicate that K-MDQ is useful for screening of bipolar spectrum disorder."