RESUMO
Objective·To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods·This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (groupⅠ), mania without psychotic symptoms (groupⅡ), mania with psychotic symptoms (group Ⅲ) and mixed state (group Ⅳ). Results·There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ, Ⅲ , Ⅳ were further compared with groupⅡ, which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ, but anxiety related symptoms was significantly higher in group Ⅰ, Ⅲ, Ⅳ. Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion·The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.
RESUMO
Objective To investigate the changes in the prescriptions of antidepressants for inpatients with psychosis from 2005 to 2008. Methods The prescriptions of antidepressants for all the inpatients with psychosis in Shanghai Mental Health Center were investigated by one day survey on each June 1st from 2005 to 2008. The most common diseases treated with antidepressants, the most commonly used antidepressants, the average dosage of antidepressants and the combination use of antidepressants were analysed. Results The most common diseases treated with antidepressants were affective disorder, schizophrenia and neurosis. The prescription rate of tricyclic antidepressants declined year by year, and that of selective serotonin reuptake inhibitors (SSRIs) fluctuated moderately, while that of antidepressants of newer generation with the other transmitter mechanisms such as venlafaxine, mitrazapine and trazodone increased gradually. Single antidepressant prescription was common, while the combination use of antidepressants accounted for a small portion. Combination use of antidepressants with one psychotropics (antipsychotics, mood stabilizer, sedative hypnotics) was common, while with two were less frequently occurred. Conclusion Prescriptions of antidepressants for patients with psychosis hospitalized in Shanghai Mental Health Center from 2005 to 2008 are relatively safe and reasonable. Antidepressants of newer generation have been widely used in clinics, and SSRIs have been serving as the major antidepressants.