難治性 情動障碍와 季節情動障碍

Refractory Affective Disorder and Seasonal Affective Disorder

Lithium carbonate has been reported to suppress both manic and depressive episodes of patients (70〜90%) with bipolar affective disorders. But 10〜30% of patients with bipolar affective disorders may not adequately responsive to lithium. Some of nonresponders have the rapid cyclicity in which four or more manic and depressive episodes occur per year. Although many factors have been reported to be associated with rapid cycling, the cause of rapid cycling is unknown. A series of alternative or adjunctive treatments have emerged that now appear to offer new treatment options for the rapid-cycling affective disorders. Tricyclic antiderpressant treatment in major depressive disorder patients has generally been reported a response rate of 60〜81%. This leaves, however, 20〜40% of patients who are classified as nonresponders. Many studies have reported the variables associated with nonresponse to traditional antidepressant therapy and a series of alternative treatments. Recently a few researchers reported seasonal affective disorders and phototherapy to this disorders. The author reveiwed the background, clinical characteristics, etiopathogenesis, treatments of rapid cycling affective disorders, refractory depressions and seasonal affective disorders. 一 412