2010年和2019年双相情感障碍住院患者的临床特征和未治疗持续时间的因素分析

doi:10.3969/j.issn.1006-7795.2022.03.014

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (3): 415-420.doi: 10.3969/j.issn.1006-7795.2022.03.014

• 精神疾病中西医结合诊疗 • 上一篇下一篇

2010年和2019年双相情感障碍住院患者的临床特征和未治疗持续时间的因素分析

刘珊珊, 房萌, 朱虹, 尹冬青, 赵燕, 赵爽, 贾竑晓^*

首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室, 北京 100088

收稿日期:2022-02-20 出版日期:2022-06-21 发布日期:2022-06-01
基金资助:
北京市医院管理中心临床医学发展专项经费资助(ZYLX202129),北京医院管理中心登峰人才(DFL20191901)。

The analysis of clinical characteristics and associating factors of untreated duration in hospitalized patients with bipolar disorder in 2010 and 2019

Liu Shanshan, Fang Meng, Zhu Hong, Yin Dongqing, Zhao Yan, Zhao Shuang, Jia Hongxiao^*

The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China

Received:2022-02-20 Online:2022-06-21 Published:2022-06-01
Contact: *E-mail:jhxlj@vip.163.com
Supported by:
Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (ZYLX202129), Beijing Hospitals Authority's Ascent Plan(DFL20191901).

摘要/Abstract

摘要： 目的分析2010年和2019年因双相情感障碍(bipolar disorder,BD)住院患者的临床特征和BD未治疗持续时间(duration of untreated BD,DUB)的影响因素。方法对首都医科大学附属北京安定医院2010年302例,2019年328例的BD住院患者进行回顾性调查,采集并分析人口学资料和临床特征。根据DUB的时长分为较短DUB组(short-DUB,S-DUB)和较长DUB组(long-DUB,L-DUB),探索不同年代L-DUB的相关因素。结果与2010年相比,2019年BD住院患者的整体受教育程度、来自于其他省份的患者比例、伴自杀观念/行为的患者比例及患者服药的依从性均较高(P<0.05),而住院时间、DUB明显缩短、总的住院次数增多,伴精神病性症状的患者比例减少,差异有统计学意义(P<0.05)。2010年中,Logistic回归分析显示未婚(OR=2.698)、病程长(OR=1.467)、首发抑郁症状(OR=0.296)、住院次数少(OR=0.635)、躁狂次数少(OR=0.476)是L-DUB的影响因素。在2019年,病程长(OR=1.191)、首发抑郁症状(OR=0.367)、首次躁狂时年龄偏小(OR=0.916)、首次确诊BD时年龄偏大(OR=1.125)是L-DUB的影响因素。结论随着年代发展,BD住院患者的DUB明显缩短。首发抑郁症状、病程长是不同年份L-DUB的相同影响因素。重视DUB及相关因素,提高对BD的甄别和早期正确诊断,是缩短DUB的关键。

关键词: 双相情感障碍, 临床特征, 双相障碍未治疗持续时间

Abstract: Objective To analyze the clinical features of hospitalized patients with bipolar disorder (BD) and the associating factors for duration of untreated BD (DUB) in 2010 and 2019. Methods A retrospective survey was conducted on BD inpatients in Beijing Anding Hospital, Capital Medical University at different years (302 cases in 2010 and 328 cases in 2019). The demographic data and clinical characteristics were collected. According to the DUB, patients were divided into short-DUB group (S-DUB) and long-DUB group (L-DUB). Then we analyzed the associating factors of L-DUB in different years. Results Compared with the patients in 2010, the education level of bipolar patients, the proportion of patients from other provinces, the proportion of patients with suicidal concept/behavior, and the number of hospitalizations in 2019 increased significantly (P<0.05). The medication compliance of patients improved significantly (P<0.05). The length of stay, the DUB, and the proportion of patients with psychotic symptoms decreased significantly (P<0.05).The Logistic regression analysis revealed that unmarried (OR=2.698), a longer duration of illness (OR=1.467), onset with depressive episode (OR=0.296), less hospitalization times (OR=0.635), and less mania times (OR=0.476) were independent factors for L-DUB in 2010. A longer duration of illness (OR=1.191), onset with depressive episode (OR=0.367), a younger age at the first manic episode (OR=0.916), and an older age at the first diagnosis of BD (OR=1.125) were independent factors for L-DUB in 2019. Conclusion The DUB was significantly shortened with the development of era. The onset with depressive episode and longer course of illness were common factors affecting DUB in different years. Paying attention to DUB and related factors and improving the identification and diagnosis of BD are the keys to shorten DUB.

Key words: bipolar disorder, clinical characteristics, duration of untreated bipolar disorder

中图分类号:

R749

刘珊珊, 房萌, 朱虹, 尹冬青, 赵燕, 赵爽, 贾竑晓. 2010年和2019年双相情感障碍住院患者的临床特征和未治疗持续时间的因素分析[J]. 首都医科大学学报, 2022, 43(3): 415-420.

Liu Shanshan, Fang Meng, Zhu Hong, Yin Dongqing, Zhao Yan, Zhao Shuang, Jia Hongxiao. The analysis of clinical characteristics and associating factors of untreated duration in hospitalized patients with bipolar disorder in 2010 and 2019[J]. Journal of Capital Medical University, 2022, 43(3): 415-420.

参考文献

[1] Harrison P J, Geddes J R, Tunbridge E M. The emerging neurobiology of bipolar disorder[J]. Trends Neurosci, 2018, 41(1): 18-30.
[2] Jones G H, Vecera C M, Pinjari O F, et al. Inflammatory signaling mechanisms in bipolar disorder[J]. J Biomed Sci, 2021, 28(1): 45.
[3] Teixeira A L, Colpo G D, Fries G R, et al. Biomarkers for bipolar disorder: current status and challenges ahead[J]. Expert Rev Neurother, 2019, 19(1): 67-81.
[4] Zhao Q, Guo T, Li Y, et al. Clinical characteristic of prodromal symptoms between bipolar I and II disorder among Chinese patients: a retrospective study[J]. BMC Psychiatry, 2021, 21(1): 275.
[5] Gore F M, Bloem P J N, Patton G C, et al. Global burden of disease in young People aged 10-24 years: a systematic analysis[J]. Lancet, 2011, 377(9783): 2093-2102.
[6] Frey B N, Andreazza A C, Houenou J, et al. Biomarkers in bipolar disorder: a positional paper from the International Society for Bipolar Disorders Biomarkers Task Force[J]. Aust N Z J Psychiatry, 2013, 47(4): 321-332.
[7] Teixeira A L, Barbosa I G, Machado-Vieira R, et al. Novel biomarkers for bipolar disorder[J]. Expert Opin Med Diagn, 2013, 7(2): 147-159.
[8] Teixeira A L, Salem H, Frey B N, et al. Update on bipolar disorder biomarker candidates[J]. Expert Rev Mol Diagn, 2016, 16(11): 1209-1220.
[9] Zhang L, Yu X, Fang Y R, et al. Duration of untreated bipolar disorder: a multicenter study[J]. Sci Rep, 2017, 7: 44811.
[10] Altamura A C, Dell'Osso B, Berlin H A, et al. Duration of untreated illness and suicide in bipolar disorder: a naturalistic study[J]. Eur Arch Psychiatry Clin Neurosci, 2010, 260(5): 385-391.
[11] Hong W, Zhang C, Xing M J, et al. Contribution of long duration of undiagnosed bipolar disorder to high frequency of relapse: a naturalistic study in China[J]. Compr Psychiatry, 2016, 70: 77-81.
[12] Ahmed G K, Elbeh K, Khalifa H, et al. Impact of duration of untreated illness in bipolar Ⅰ disorder (manic episodes) on clinical outcome, socioecnomic burden in Egyptian population[J]. Psychiatry Res, 2021, 296: 113659.
[13] Buoli M, Cesana B M, Fagiolini A, et al. Which factors delay treatment in bipolar disorder? A nationwide study focussed on duration of untreated illness[J]. Early Interv Psychiatry, 2021, 15(5): 1136-1145.
[14] Drancourt N, Etain B, Lajnef M, et al. Duration of untreated bipolar disorder: missed opportunities on the long road to optimal treatment[J]. Acta Psychiatr Scand, 2013, 127(2): 136-144.
[15] McCraw S, Parker G, Graham R, et al. The duration of undiagnosed bipolar disorder: effect on outcomes and treatment response[J]. J Affect Disord, 2014, 168: 422-429.
[16] Oyffe I, Shwizer R, Stolovy T. The association between diagnosis, treatment delay and outcome among patients with bipolar disorders[J]. Psychiatr Q, 2015, 86(1): 95-105.
[17] Dagani J, Signorini G, Nielssen O, et al. Meta-analysis of the interval between the onset and management of bipolar disorder[J]. Can J Psychiatry, 2017, 62(4): 247-258.
[18] Anon. Implementation of the international statistical classification of diseases and related health problems, tenth revision (ICD-10)[J]. Epidemiol Bull, 1997, 18(1): 1-4.
[19] Fico G, Anmella G, Gomez-Ramiro M, et al. Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study[J]. J Affect Disord, 2021, 294: 513-520.
[20] Berk M, Berk L, Dodd S, et al. Stage managing bipolar disorder[J]. Bipolar Disord, 2014, 16(5): 471-477.
[21] Conus P, Macneil C, McGorry P D. Public health significance of bipolar disorder: implications for early intervention and prevention[J]. Bipolar Disord, 2014, 16(5): 548-556.
[22] Pompili M, Gonda X, Serafini G, et al. Epidemiology of suicide in bipolar disorders: a systematic review of the literature[J]. Bipolar Disord, 2013, 15(5): 457-490.
[23] Dong M, Lu L, Zhang L, et al. Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies[J]. Epidemiol Psychiatr Sci, 2019, 29: e63.
[24] Medeiros G C, Senço S B, Lafer B, et al. Association between duration of untreated bipolar disorder and clinical outcome: data from a Brazilian sample[J]. Braz J Psychiatry, 2016, 38(1): 6-10.
[25] Phillips M L, Kupfer D J. Bipolar disorder diagnosis: challenges and future directions[J]. Lancet, 2013, 381(9878): 1663-1671.
[26] Serafini G, Gonda X, Monacelli F, et al. Possible predictors of age at illness onset and illness duration in a cohort study comparing younger adults and older major affective patients[J]. J Affect Disord, 2018, 225: 691-701.

2010年和2019年双相情感障碍住院患者的临床特征和未治疗持续时间的因素分析

The analysis of clinical characteristics and associating factors of untreated duration in hospitalized patients with bipolar disorder in 2010 and 2019

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	贾静, 陈文明, 李燕郴. 多发性骨髓瘤伴中枢侵犯临床特征及预后分析[J]. 首都医科大学学报, 2023, 44(1): 161-166.
[2]	张静涛, 王欣然, 韩斌如, 强莹, 刘雪琪, 张毅. 老年肺癌患者胸腔镜肺切除术后并发心律失常的临床特征及危险因素分析[J]. 首都医科大学学报, 2022, 43(4): 564-569.
[3]	邵琳琳, 朱思莹, 邢洁, 武珊珊, 朱圣韬, 张澍田. 原发性胃肠道淋巴瘤的临床特征和内镜特点分析[J]. 首都医科大学学报, 2022, 43(2): 205-209.
[4]	詹敏敏, 马慧萱, 康雪纯, 鲁新亮, 宫淑婷, 邹琦, 吕继辉, 周爱红, 贾建平, 魏翠柏. 轻中度阿尔茨海默病患者精神行为学症状特点及关联性分析[J]. 首都医科大学学报, 2021, 42(3): 354-359.
[5]	李自艳, 刘鑫子, 杜渐, 王昊, 杨秋莉, 贾竑晓. 双相情感障碍的中医五态人格特征初探[J]. 首都医科大学学报, 2021, 42(3): 408-411.
[6]	岳晓艳, 李凤杰, 蒋志锋, 朱娅楠. 慢性阻塞性肺疾病急性加重合并下肢深静脉血栓的临床特征及危险因素[J]. 首都医科大学学报, 2021, 42(1): 153-157.
[7]	张维, 侯维, 李侗曾, 李爱新, 潘闻, 金荣华, 梁连春, 胡中杰. 74例新型冠状病毒肺炎临床特征分析[J]. 首都医科大学学报, 2020, 41(2): 161-167.
[8]	赵丽东, 杨林花. 30例血栓性血小板减少性紫癜临床分析[J]. 首都医科大学学报, 2019, 40(3): 454-457.
[9]	王蔚, 苏嘉明, 袁东波, 张伟, 陈卫红, 孙兆林, 朱建国. 微管相关蛋白1A在前列腺癌中的表达与其临床特征的关系[J]. 首都医科大学学报, 2019, 40(1): 65-71.
[10]	马小雯, 董春霞, 陈剑芳, 王梅芳, 张睿娟, 张建华, 杨林花. 外周血单核细胞绝对计数对慢性淋巴细胞白血病预后判断的价值[J]. 首都医科大学学报, 2018, 39(4): 581-585.
[11]	陈玙, 王梅芳, 程芳芳, 申星, 赵丽东, 杨林花. 老年原发免疫性血小板减少症患者临床特征及预后分析[J]. 首都医科大学学报, 2018, 39(2): 277-281.
[12]	池添雨, 张玫. 老年人慢性胰腺炎的病因及临床特点分析[J]. 首都医科大学学报, 2018, 39(2): 286-291.
[13]	李晓虹;刘敏;罗小年;王刚. 糖原合成酶激酶3与双相情感障碍[J]. 首都医科大学学报, 2008, 29(4): 436-439.
[14]	丁成云;徐群渊;栾国明. 难治性癫痫的病理学与多药耐药基因表达的研究[J]. 首都医科大学学报, 2005, 26(6): 714-718.
[15]	陈东宁;谭杰;张沪生. 肺心病伴发急性心肌梗死的临床特征[J]. 首都医科大学学报, 2001, 22(1): 36-38.