우울증 환자에서 양극성장애로의 전환을 예측하는 재발성 주요우울삽화 횟수의 절단값 산정 : 일 대학병원의 5년 후향적 의무기록 연구 = Determining the Cut-Off for Recurrent Depressive Episode to Predict Diagnostic Conversion from Unipolar Depression to Bipolar Disorder : 5-Year Retrospective Study in One University Hospital

다국어 초록 (Multilingual Abstract)

Objectives : The aim of this study was to determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder by means of retrospective reviews of medical records. Methods : The medical records of 250 patients with a diagnosis of major depressive disorder for at least 5 years were retrospectively reviewed for this study. We reviewed DSM-IV diagnosis and detailed clinical information at the index admission with assessments made every year after discharge to determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder. Optimal cut off scores were developed through the use of receiver operating characteristic (ROC) curves. Results : Receiver operating characteristic curve analysis indicated that the cut-off scores for recurrent depressive episode of more than three times would predict bipolar disorder (area under curve=0.647, sensitivity=0.435, specificity=0.819, positive predictive value=0.351, negative predictive value=0.865). Conclusion :These findings suggest that it could predict the best diagnostic conversion from unipolar depression to bipolar disorder when depressive episodes are recurrent more than three times. Based on these findings, it will be able to promote the accuracy of diagnosis and the efficiency of treatment. To validate our results, longitudinal follow up studies will be needs.

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