Soreca Isabella, Fagiolini Andrea, Frank Ellen, Houck Patricia R, Thompson Wesley K, Kupfer David J
Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213, USA.
J Psychiatr Res. 2008 Sep;42(11):956-61. doi: 10.1016/j.jpsychires.2007.10.009. Epub 2008 Feb 20.
This study was aimed at evaluating general medical burden in a group of 111 patients with bipolar I disorder.
Data were drawn from participants entering the Bipolar Disorder Center for Pennsylvanians (BDCP) protocol. General medical burden was assessed by completing the Cumulative Illness Rating Score (CIRS) from chart review.
The mean age of the sample was 42.1 (11.5), mean CIRS total score was 4.7 (2.9), and mean number of categories endorsed was 3.4 (1.7). Medical burden showed a positive relationship with increasing age and with duration of illness. CIRS scores and number of organ/system categories endorsed were significantly higher in patients with more than 21 years of illness than in patients with 0-9 years of illness (p<.0001) or with 10-20 years of illness (p<.0001). Medical burden was related to duration of illness even after controlling for age. The most frequently endorsed illness categories were cardiovascular disease, (with hypertension and hyperlipidemia being the most frequent conditions) and endocrine/metabolic (with obesity, thyroid dysfunction, and type 2 diabetes being the most common conditions).
Patients with bipolar disorder carry a substantial burden of general medical conditions, related to age and duration of illness. These results suggest that the development and testing of specific interventions that target medical risk factors and medical burden in patients with bipolar disorder are urgently needed, especially early in the course of the illness, when patients appear to accumulate medical comorbidity at a rapid rate.
本研究旨在评估111例双相I型障碍患者的总体医疗负担。
数据来自参与宾夕法尼亚双相障碍中心（BDCP）方案的参与者。通过病历审查完成累积疾病评分量表（CIRS）来评估总体医疗负担。
样本的平均年龄为42.1岁（标准差11.5），CIRS总分平均为4.7分（标准差2.9），认可的类别平均数量为3.4个（标准差1.7）。医疗负担与年龄增长和病程呈正相关。病程超过21年的患者CIRS评分和认可的器官/系统类别数量显著高于病程0 - 9年的患者（p <.0001）或病程10 - 20年的患者（p <.0001）。即使在控制年龄后，医疗负担仍与病程相关。最常认可的疾病类别是心血管疾病（高血压和高脂血症最为常见）以及内分泌/代谢疾病（肥胖、甲状腺功能障碍和2型糖尿病最为常见）。
双相障碍患者承担着与年龄和病程相关的大量总体医疗状况负担。这些结果表明，迫切需要针对双相障碍患者的医疗风险因素和医疗负担开发和测试特定干预措施，尤其是在疾病早期，此时患者似乎迅速积累合并症。
