不同发病年龄的双相障碍患者的临床表现
Comparison of clinically relevant factors in bipolar disorder patients with different age of onset
马严 1田霄翌 2黄悦勤 2刘肇瑞 2邓咏妍 2周亮 3刘燕 4刘波 5章杰 6龚元东 7付祥 8赵琼仙 9卢瑾 10沙万年 1合浩 11沈宗霖 10张婷婷 2陈文明1
作者信息
- 1. 普洱第二人民医院,云南普洱 665000
- 2. 北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京 100083
- 3. 广州医科大学附属脑科医院,广州 510370
- 4. 济宁医学院,山东济宁 272013
- 5. 荆州市精神卫生中心,湖北荆州 434000
- 6. 中山市第三人民医院,中山市心理卫生中心,广东中山 528451
- 7. 山东省精神卫生中心,济南 250014
- 8. 玉溪市第二人民医院,云南玉溪 653100
- 9. 楚雄州第二人民医院,云南楚雄 675000
- 10. 昆明医科大学第一附属医院精神科,昆明 650032
- 11. 云南省精神病医院,昆明 650224
- 折叠
摘要
目的:比较不同发病年龄的双相障碍患者的临床特征、治疗情况和生理指标.方法:选取符合精神障碍诊断与统计手册第5版(DSM-5)双相障碍诊断标准的患者380例,由精神科医生采用简明国际神经精神访谈进行疾病诊断,用自编临床资料访谈表和功能大体评定量表进行临床特征、治疗情况和生理指标的评估,以21岁和35岁作为双相障碍发病年龄的分界点,进行logistic回归和多重线性回归分析.结果:早发组199例(52.4％),中发组121例(31.8％),晚发组60例(15.8％).首次诊断为抑郁症的比例在早发组为26.6％,中发组为23.1％,晚发组为11.7％.与早发组相比,中发组(OR=2.22)和晚发组(OR=4.99)处于抑郁发作状态的风险更高;晚发组(OR=6.74)罹患双相Ⅱ型障碍风险为6.74倍;中发组(β=-1.52)和晚发组(β=-4.29)的延迟治疗时间更短,中发组(β=-1.62)和晚发组(β=-3.14)的住院次数更少,中发组(β=-28.39)和晚发组(β=-31.47)的尿酸含量更低,中发组(β=-0.23)的总胆固醇的含量更低.结论:不同发病年龄的双相障碍患者在临床特征、治疗情况和生理指标方面存在差异.
Abstract
Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.
关键词
双相障碍/首发年龄/临床症状/生理指标/治疗Key words
bipolar disorder/age of onset/clinical characteristics/physiological indicators/treatment引用本文复制引用
基金项目
国家重点研发计划(2017YFC0907800)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据