最近审阅: 27 十月 2020
最近更新: 13 九月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 重性抑郁发作
  • 躁狂发作或混合发作
  • 轻躁狂发作
  • 自尊心膨胀或自大
  • 睡眠需求降低
  • 比平时更多话,或者感觉有压力要不停地说话
  • 思维奔逸,或者主观体验到思维奔逸
  • 注意力分散
  • 目的导向的活动增加或精神运动性激越
  • 过度参与很可能带来不利后果的快感活动
  • 功能障碍
  • 无物质滥用
  • 无潜在躯体疾病原因
  • 不应由身体抗抑郁药物治疗或其他处方药引起

危险因素

  • 双相情感障碍家族史
  • 在 20 岁前出现心境障碍发作
  • 应激性的生活事件
  • 抑郁既往史
  • 物质滥用障碍的终身病史
  • 出现焦虑障碍
  • 肥胖
  • 心血管疾病

诊断性检查

首要检查

  • 精神疾病的初级医疗保健评估 (PRIME-MD)
  • 患者健康问卷 (PHQ-9)
  • 心境障碍问卷调查 (MDQ)
  • 复合性国际诊断访谈 (CIDI)
  • 双极性指数
  • 杨氏躁狂评定量表 (YMRS)
  • 全血细胞计数(FBC)
  • 甲状腺功能检测
  • 血清维生素 D
  • 毒理学筛查
更多 首要检查

需考虑的检查

  • 空腹血脂检查
  • 空腹血糖
  • 颅脑 MRI 扫描
更多 需考虑的检查

治疗流程

撰稿人

Assistant Professor of Psychiatry

University of Texas Health Science Center

Houston

TX

利益声明

SS has received intravenous citalopram for research from Lundbeck UK and participated as a speaker organised by Global Medical Education. SS has third-party indirect share in the form of convertible note in Flow MedTech, Inc (a medical device start-up company).

Dr Sudhakar Selvaraj would like to gratefully acknowledge Dr Prashant Gajwani and Dr David J. Muzina, previous contributors to this topic. PG has served on the speakers' bureau for Merck and Sunovion. DJM is an author of a number of references cited in this topic. DJM has previously received honoraria for research support from Repligen Co. He has also previously received honoraria as a speaker and/or advisor from AstraZeneca, Pfizer, BMS, Wyeth, Sepracor, and GSK. DJM is a full-time employee of Medco.

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Head

Mood Disorders Psychopharmacology Unit

University Health Network

Associate Professor of Psychiatry and Pharmacology

University of Toronto

Ontario

Canada

利益声明

RM has received research funds from Stanley Medical Research Institute and National Alliance for Research on Schizophrenia and Depression (NARSAD). RM is on the advisory boards for AstraZeneca, Bristol-Myers Squibb, France Foundation, GlaxoSmithKline Janssen-Ortho, Solvay/Wyeth, Eli Lilly, Organon, Lundbeck, Biovail, Pfizer, Shire, and Schering-Plough. RM is on the speakers' bureau for Janssen-Ortho, AstraZeneca, Eli Lilly, Lundbeck, Biovail, and Wyeth. RM has received research grants from Eli Lilly, Janssen-Ortho, and Shire.

Professor of Psychological Medicine

University of Newcastle

Honorary Professor

Psychological Treatments Research

Institute of Psychiatry

London

University Department of Psychiatry

Royal Victoria Infirmary

Newcastle upon Tyne

UK

利益声明

JS has received remuneration for attending advisory boards for AstraZeneca, BSM-Otsuka, Eli Lilly, GSK, and Sanofi-Aventis.

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