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老年双相情感障碍和重度抑郁症的医疗负担

Medical burden in late-life bipolar and major depressive disorders.

作者信息

Gildengers Ariel G, Whyte Ellen M, Drayer Rebecca A, Soreca Isabella, Fagiolini Andrea, Kilbourne Amy M, Houck Patricia R, Reynolds Charles F, Frank Ellen, Kupfer David J, Mulsant Benoit H

机构信息

Intervention Research Center for Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.

出版信息

Am J Geriatr Psychiatry. 2008 Mar;16(3):194-200. doi: 10.1097/JGP.0b013e318157c5b1.

Abstract

BACKGROUND

Elderly patients with bipolar disorder have been found to have higher mortality than those with major depressive disorder. The authors compare medical burden in elderly patients with bipolar disorder with that in those with major depressive disorder.

METHODS

Fifty-four patients with bipolar I or II disorder who were 60 years of age and older were equated 1-to-2 to 108 patients with nonpsychotic, major depressive disorder according to age, sex, race, and lifetime duration of mood disorder illness. Variables examined included the following: Cumulative Illness Rating Scale for Geriatrics (CIRS-G) total scores, body mass index (BMI), and CIRS-G subscale scores.

RESULTS

Compared with patients with major depressive disorder, patients with bipolar disorder had similar levels of general medical comorbidity on the CIRS-G total score and number of systems affected but higher BMI. After controlling for multiple comparisons, the endocrine/metabolic and respiratory subscale scores on the CIRS-G were higher for patients with bipolar disorder.

CONCLUSION

Although overall medical burden appears comparable in elderly patients with bipolar and those with major depressive disorder, patients with bipolar disorder have higher BMI and greater burden of endocrine/metabolic and respiratory disease.

摘要

背景

研究发现,老年双相情感障碍患者的死亡率高于重度抑郁症患者。作者比较了老年双相情感障碍患者与重度抑郁症患者的医疗负担。

方法

将54名60岁及以上的双相I型或II型障碍患者按照年龄、性别、种族和心境障碍疾病的终生病程1:2匹配108名非精神病性重度抑郁症患者。所检查的变量包括:老年累积疾病评定量表(CIRS-G)总分、体重指数(BMI)以及CIRS-G子量表分数。

结果

与重度抑郁症患者相比,双相情感障碍患者在CIRS-G总分和受影响系统数量方面的总体医疗合并症水平相似,但BMI更高。在控制多重比较后,双相情感障碍患者的CIRS-G内分泌/代谢和呼吸子量表分数更高。

结论

虽然老年双相情感障碍患者和重度抑郁症患者的总体医疗负担似乎相当,但双相情感障碍患者的BMI更高,内分泌/代谢和呼吸系统疾病负担更大。

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