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1、精神病学Affective(mood)DisordersXIEGuang-rongM.D.DefinitionAffectivedisordersarecharacterizedbyobviousandpersistentelationordepressionofmood.Themooddisturbanceiscommonlyassociatedwithcognitiveandbehavioralchanges.Inseverecases,psychoticsymptoms,suchashallucinationanddelusion,m
2、aybeobserved.Thereisarecurrenttendency.Incertaincases,anepisodemaybecomechronicandresidualsymptomsareobserved.TheClassificationofAffectiveDisordersManicepisode(mania)Depressionsingleepisode(unipolar)recurrentepisodeWithorAffectivewithoutDisordersBipolar-I(withmania)Psychot
3、icBipolarBipolar-II(withhypomania)symptomdisordersMixedtypeRapid-cyclingbipolardisorderDysthymiaCyclothymiadisorderClinicaldescriptionofmooddisordersTheepisodeSeverityMild,moderate,orsevereTypeDepressive,manic,mixedSpecialfeaturesWithmelancholicsymptomsWithneuroticsymptoms
4、WithpsychoticsymptomsWithagitationWithretardationorstuporThecourseUnipolarorbipolarAetiologyPredominantlyreactivePredominantlyendogenousEtiologyGeneticCausesFamilyStudies:InastudyattheNationalInstituteofMentalHealth,25%ofrelativesofbipolarprobandswerefoundtohavebipolardiso
5、rderorunipolarillness(depression)themselves,comparedto20%ofrelativesofunipolarprobandsand7%ofrelativesofcontrolsubjects.Somedatahavesupportedmultifactorialmodels,Thesemodelsimplymultiplefactors:genetic,environmental,orboth.Analternativeexplanationisheterogeneity.Inotherwor
6、ds,singlemajorgenesareimportantinatleastsomefamilies,butitisnotthesamegeneineachfamily.Twinstudies:Onaverage,MZtwinpairsshowconcordance65%ofthetime,andDZtwinpairsshowconcordance14%ofthetime.AdoptionStudies:Inonestudy,theriskforaffectivedisorderinthebiologicalrelativesofbip
7、olarprobandswas31%asopposedto2%intherelativesofcontrolprobands.Theriskinbiologicalrelativesofadoptedbipolarprobandswassimilartotheriskinrelativesofbipolarprobandswhowerenotadoptedaway(26%).Adoptiverelativesdidnotshowincreasedrisk.Adoptionstudiesthatusedabroaderclassofaffec
8、tiveprobandsshowedevidenceforgeneticfactorsbutalsopossibleenvironmentalinfluences.Molecul
