双相障碍识别诊疗和治疗进展.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 1：讨论：急性期重症患者；有拒食、自杀、自伤或伤人风险；依从性差且不能控制自己的行为，骚扰社会和家庭；缺乏有效监护人，伴有明显精神病症状；药物治疗效果差需要电休克治疗；共病重要器官疾病或有物质及酒依赖需同时治疗者；老年、孕妇、或身体虚弱需要密切监护者 2：心境稳定剂在决策中的地位 3：什么时候需要调整治疗方案？在什么基础上调整治疗方案？如何调整？ * * * * * * MDQ13项中阳性条目数≥6项的共460例，占总样本的30.9%。HCL-32中阳性条目数≥12项的共629例(占42.3%)。 在做3分类(UP/BPI/BPII)划界分时，MDQ结果只取13项中阳性数目≥6，与量表原作者说设定的 阳性条目≥7 AND 2种或以上症状同期发生过 AND 中度或重度影响：才能考虑BD 不同，按照原作者的诊断标准我们所得到的双相障碍阳性率为7.0%。 * * 从该图可以观察到，MINI、MDQ、HCL-32检出双相1型的能力基本一致(7.9% 6.6% 5%)，区别主要在于它们对双相II型检出率的差异(12.9%、24.3%、37.3%)。HCL-32＞MDQ＞MINI * * Please find below a list of disorders that are currently proposed for the diagnostic category, Bipolar and Related Disorders. This category contains diagnoses that were listed in DSM-IV under the chapter of Mood Disorders. The Mood Disorders Work Group has been responsible for addressing these revisions. Among the most recent changes put forth by the work group concerns the?proposed removal of the bereavement exclusion in Major Depressive Episode. Along with removing the exclusion, the work group is proposing the addition of a footnote to accompany the diagnostic criteria for Major Depressive Episode that would help clinicians differentiate bereavement and other loss reactions from Major Depression.?Furthermore, increased energy/activity has been added as a core symptom of Manic Episodes and Hypomanic Episodes. * * Updated April-28-2012 Bipolar I Disorder A. Presence (or history) of one or more Manic Episodes (see Critieria for Manic Episode). B. The Manic Episode(s) are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenica, Schozphreniform Disorder, Delusional Disorder, or Psychotic Disorder NEC. C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify if: Current or Most Recent Episode Manic Current or Most Recent Episode Hypomanic Current or Most Recent Episode Dep