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中国全科医学

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初级保健视角下双相Ⅱ型情感障碍与抑郁障碍的鉴别诊断研究进展

姚丁烨1，2，罗桂平3，孙俊生1，2*，李慧4   

  1. 1.518116 广东省深圳市，广州中医药大学深圳临床医学院；2.518116 广东省深圳市龙岗中心医院全科医学科；3.518116 广东省深圳市龙岗区人民医院中央悦城社区健康服务中心；4.515063 广东省汕头市，汕头大学医学院精神卫生中心
    姚丁烨与罗桂平为共同第一作者
  • 收稿日期:2024-12-16 接受日期:2025-01-09
  • 通讯作者: 孙俊生，主任医师；E-mail：junshengsun@126.com
  • 基金资助:
    广东省本科高校教学质量与教学改革工程项目（粤教高函〔2023〕4 号，粤教高函〔2024〕30 号）；深圳市龙岗区医学学科建设经费资助；汕头大学医学院本科教学改革与研究项目（24JXGG05）

Identifying Bipolar Ⅱ Disorder and Depressive Disorder in Primary Care

YAO Dingye1，2，LUO Guiping3，SUN Junsheng1，2*，LI Hui4   

  1. 1.Shenzhen Clinical College of Medicine，Guangzhou University of Chinese Medicine，Shenzhen 5181116，China；2.Department of General Practice，Longgang Central Hospital of Shenzhen，Shenzhen 5181116，China；3.Yuecheng Central Community Health Service Center of Shenzhen Longgang District People's Hospital，Shenzhen 518116，China；4.The Mental Health Center，Shantou University Medical College，Shantou 515063，China
  • Received:2024-12-16 Accepted:2025-01-09
  • Contact: SUN Junsheng，Chief physician；E-mail：junshengsun@126.com

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摘要： 双相Ⅱ型情感障碍与抑郁障碍在临床表现上存在重叠，使得在初级保健领域的两者鉴别面临严峻挑战。早期准确诊断对于改善患者预后至关重要，全科医生作为初级保健体系中的首诊医师，在疾病的早期筛查、识别和初始治疗方案制定中发挥重要作用。然而，目前全科医生在准确鉴别双相Ⅱ型情感障碍与抑郁障碍方面仍存在困难。本文总结了近年来双相Ⅱ型情感障碍与抑郁障碍鉴别诊断的研究进展，重点从临床特征、筛查工具的应用及随访策略等方面阐述两种疾病在初级保健领域的鉴别方法，并探讨现有筛查工具的优势与局限。此外，文章也展望了人工智能、生物标志物及远程监测等工具在提升鉴别诊断准确性方面的应用前景，以期为后续研究和临床实践提供参考。

关键词: 初级保健；全科医生；双相Ⅱ型情感障碍；抑郁障碍；诊断, 鉴别

Abstract: The overlap in clinical presentation between bipolar Ⅱ（BD- Ⅱ ） disorder and depressive disorders（DD） poses a significant challenge for differential diagnosis in primary care. Early and accurate diagnosis is critical to improve patient prognosis，and general practitioners（GPs），as frontline healthcare providers，play a pivotal role in initial screening，diagnosis，and treatment planning. However，GPs currently face challenges in accurately distinguishing BD- Ⅱ from DD. This paper summarises recent research advances in the differential diagnosis of BD- Ⅱ and DD，with a focus on clinical features，use of screening tools and follow-up strategies，it further evaluates the strengths and limitations of existing screening instruments in primary care settings. Additionally，emerging tools such as artificial intelligence，biomarkers and remote monitoring technologies are discussed for their potential to enhance diagnostic accuracy，offering valuable insights for follow-up research and clinical practice.

Key words: Primary care；General practitioners；Bipolar Ⅱ disorder；Depressive disorder；Diagnosis, differential

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