Albert Umberto, Rosso Gianluca, Maina Giuseppe, Bogetto Filippo
Department of Neurosciences, Mood nad Anxiety Disorders Unit, University of Turin, Italy, Torino, Italy.
J Affect Disord. 2008 Jan;105(1-3):297-303. doi: 10.1016/j.jad.2007.05.020. Epub 2007 Jul 6.
Few studies investigated the impact of anxiety disorder comorbidity on health-related quality of life (HRQoL) of bipolar patients and none examined bipolar subtypes differences. The aim of the study was 1) to determine comorbidity rates for anxiety disorders in euthymic bipolar subjects, comparing bipolar type I and II disorders (BDI and BDII), and 2) to compare within each group HRQoL measures in subjects with and without anxiety comorbidity.
Comorbidity was evaluated through the SCID-I; HRQoL was assessed using the 36-Item Short-Form Health Survey (SF-36). All subjects were euthymic since at least 2 months, as confirmed by a HAM-D <8 and a YMRS <6. A comparison was made for SF-36 scores between subjects (all bipolars, BDI and BDII) with and without anxiety disorders.
105 patients were enrolled: 44 with BDI and 61 with BDII. Current and lifetime anxiety disorders comorbidities were 32.4% and 41.0% for all bipolars, 31.8% and 40.9% for BDI and 32.8% and 41.0% for BDII. BDI patients differed in several SF-36 domains from BDII subjects, which reported a poorer HRQoL. A current and lifetime comorbid anxiety disorder was associated with a poorer HRQoL considering all bipolars; when examining separately BDI and II subjects, however, the deleterious effect was restricted to BDI patients.
The cross-sectional assessment of HRQoL, the generic instrument used (SF-36) and the small sample size.
Our study confirms the high comorbidity rates for anxiety disorders in bipolar subjects and provides evidence that anxiety comorbidity impacts HRQoL in subjects with BDI and not BDII.
很少有研究调查焦虑症共病对双相情感障碍患者健康相关生活质量（HRQoL）的影响，且没有研究考察双相情感障碍亚型之间的差异。本研究的目的是：1）确定心境正常的双相情感障碍患者中焦虑症的共病率，比较双相I型和II型障碍（BDI和BDII）；2）比较每组中合并和未合并焦虑症的患者的HRQoL指标。
通过《精神障碍诊断与统计手册》第一版（SCID-I）评估共病情况；使用36项简明健康调查（SF-36）评估HRQoL。所有受试者至少2个月来心境正常，汉密尔顿抑郁量表（HAM-D）评分<8且杨氏躁狂量表（YMRS）评分<6证实了这一点。比较了合并和未合并焦虑症的受试者（所有双相情感障碍患者、BDI和BDII）的SF-36评分。
共纳入105例患者：44例BDI患者和61例BDII患者。所有双相情感障碍患者当前和终生焦虑症共病率分别为32.4%和41.0%，BDI患者分别为31.8%和40.9%，BDII患者分别为32.8%和41.0%。BDI患者在几个SF-36领域与BDII患者不同，BDII患者的HRQoL较差。考虑所有双相情感障碍患者时，当前和终生共病焦虑症与较差的HRQoL相关；然而，分别检查BDI和BDII患者时，有害影响仅限于BDI患者。
HRQoL的横断面评估、所使用的通用工具（SF-36）以及样本量小。
我们的研究证实了双相情感障碍患者中焦虑症的高共病率，并提供证据表明焦虑症共病影响BDI患者而非BDII患者的HRQoL。
