McElroy S L, Altshuler L L, Suppes T, Keck P E, Frye M A, Denicoff K D, Nolen W A, Kupka R W, Leverich G S, Rochussen J R, Rush A J, Post R M
Stanley Foundation Bipolar Treatment Outcome Network, Department of Psychiatry, University of Cincinnati College of Medicine, OH 45267-0559, USA.
Am J Psychiatry. 2001 Mar;158(3):420-6. doi: 10.1176/appi.ajp.158.3.420.
Bipolar disorder often co-occurs with other axis I disorders, but little is known about the relationships between the clinical features of bipolar illness and these comorbid conditions. Therefore, the authors assessed comorbid lifetime and current axis I disorders in 288 patients with bipolar disorder and the relationships of these comorbid disorders to selected demographic and historical illness variables.
They evaluated 288 outpatients with bipolar I or II disorder, using structured diagnostic interviews and clinician-administered and self-rated questionnaires to determine the diagnosis of bipolar disorder, comorbid axis I disorder diagnoses, and demographic and historical illness characteristics.
One hundred eighty-seven (65%) of the patients with bipolar disorder also met DSM-IV criteria for at least one comorbid lifetime axis I disorder. More patients had comorbid anxiety disorders (N=78, 42%) and substance use disorders (N=78, 42%) than had eating disorders (N=9, 5%). There were no differences in comorbidity between patients with bipolar I and bipolar II disorder. Both lifetime axis I comorbidity and current axis I comorbidity were associated with earlier age at onset of affective symptoms and syndromal bipolar disorder. Current axis I comorbidity was associated with a history of development of both cycle acceleration and more severe episodes over time.
Patients with bipolar disorder often have comorbid anxiety, substance use, and, to a lesser extent, eating disorders. Moreover, axis I comorbidity, especially current comorbidity, may be associated with an earlier age at onset and worsening course of bipolar illness. Further research into the prognostic and treatment response implications of axis I comorbidity in bipolar disorder is important and is in progress.
双相情感障碍常与其他I轴疾病共病，但对于双相情感障碍的临床特征与这些共病情况之间的关系知之甚少。因此，作者评估了288例双相情感障碍患者的终生共病和当前的I轴疾病，以及这些共病与选定的人口统计学和既往疾病变量之间的关系。
他们对288例I型或II型双相情感障碍门诊患者进行了评估，使用结构化诊断访谈以及临床医生管理和自评问卷来确定双相情感障碍的诊断、共病的I轴疾病诊断以及人口统计学和既往疾病特征。
187例（65%）双相情感障碍患者还符合至少一种终生共病I轴疾病的DSM-IV标准。共病焦虑症（N = 78，42%）和物质使用障碍（N = 78，42%）的患者比共病饮食失调（N = 9，5%）的患者更多。I型和II型双相情感障碍患者在共病情况上没有差异。终生I轴共病和当前I轴共病均与情感症状和综合征性双相情感障碍的发病年龄较早有关。当前I轴共病与随着时间推移出现周期加速和更严重发作的病史有关。
双相情感障碍患者常伴有共病焦虑、物质使用障碍，在较小程度上还伴有饮食失调。此外，I轴共病，尤其是当前共病可能与双相情感障碍的发病年龄较早和病情恶化有关。对双相情感障碍中I轴共病的预后和治疗反应影响进行进一步研究很重要，且正在进行中。
