双相障碍诊断乱象

普洛韦登斯,罗得岛 – 在过去的几年里,许多专家都认为双相障碍(bipolar disorder)-- 一种会造成重度社会心理病态和高死亡率的严重疾病—没有得到足够的重视,特别在患有严重抑郁症的病人中更是如此。即便是被诊断为双相障碍的病人,从最初的求诊到最后的确诊也往往会经历十多年的时间。

对抑郁症患者双相障碍的认识不够在临床上的反映包括情绪稳定药物的使用不足和快速“循环”(即在狂躁与抑郁阶段之间摇摆)风险的增加。然而,同心协力提升对双相障碍的认识的努力很可能产生了反作用。在过去几年里我们观察到了另一种极端的现象—过度诊断。

在我自己的从医经历中,我和同事们碰到过一些病人反映说他们虽然没有过狂躁或轻度狂躁的情况,但也曾被诊断为双相障碍。当然,我们也的确看到有些因抑郁求诊的病人确实患有双相障碍。然而,过度诊断的情况似乎比诊断不足的情况多。

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