Gutiérrez-Rojas Luis, Gurpegui Manuel, Ayuso-Mateos José L, Gutiérrez-Ariza José A, Ruiz-Veguilla Miguel, Jurado Dolores
Psychiatry Service, Complejo Hospitalario Ciudad de Jaén, Jaén, Spain.
Bipolar Disord. 2008 Jul;10(5):625-34. doi: 10.1111/j.1399-5618.2008.00604.x.
To compare the Quality of Life (QoL) of bipolar disorder (BD) patients with that of the general population; and, within the BD patients, to find the demographic and clinical variables associated with low QoL, controlling for the effects of potential confounders.
Based on the 25th percentile of the physical (PCS) and the mental (MCS) component scores (PCS <53 and MCS < 50, respectively) of the Medical Outcomes Survey 36-item Short-Form Health-Survey (SF-36) of a general population representative sample (n = 1,210), we compared by logistic regression the QoL of 48 euthymic and 60 non-euthymic BD outpatients and the general population. Within BD patients, we analyzed the clinical and course-of-illness variables associated with low physical and mental QoL, including manic and depressive symptoms and consumption of addictive substances; in addition, we calculated the partial correlation of the different variables with the dimensional PCS and MCS through multiple linear regression.
Low physical QoL was significantly more frequent among both euthymic [odds ratio (OR) = 3.5; 95% confidence interval (CI): 1.9-6.5] and non-euthymic (OR = 4.0; 95% CI: 2.3-7.0) BD patients than in the general population; the respective values for low mental QoL were OR = 2.2; 95% CI: 1.2-4.0 and OR = 8.5; 95% CI: 4.6-15.7. Low mental QoL was more frequent among non-euthymic than euthymic BD patients (OR = 3.9; 95% CI: 1.6-9.1). Within BD patients, low mental QoL was associated with the length of illness (or early onset), the presence of depressive symptoms, nicotine dependence and the lack of social support.
Among the BD patients, who experience lower physical and mental QoL even in a euthymic period, the optimal control of depressive symptoms as well as the availability of social support may enhance their well-being.
比较双相情感障碍(BD)患者与普通人群的生活质量(QoL);并在BD患者中,找出与低生活质量相关的人口统计学和临床变量,同时控制潜在混杂因素的影响。
基于一般人群代表性样本(n = 1210)的医学结局研究36项简短健康调查(SF - 36)的身体(PCS)和精神(MCS)成分得分的第25百分位数(PCS分别<53,MCS分别<50),我们通过逻辑回归比较了48名心境正常和60名心境异常的BD门诊患者与普通人群的生活质量。在BD患者中,我们分析了与低身体和精神生活质量相关的临床和病程变量,包括躁狂和抑郁症状以及成瘾物质的使用情况;此外,我们通过多元线性回归计算了不同变量与维度PCS和MCS的偏相关性。
心境正常的BD患者[优势比(OR)= 3.5;95%置信区间(CI):1.9 - 6.5]和心境异常的BD患者(OR = 4.0;95% CI:2.3 - 7.0)中身体生活质量低的情况均显著多于普通人群;精神生活质量低的相应值分别为OR = 2.2;95% CI:1.2 - 4.0和OR = 8.5;95% CI:4.6 - 15.7。心境异常的BD患者中精神生活质量低的情况比心境正常的BD患者更常见(OR = 3.9;95% CI:1.6 - 9.1)。在BD患者中,精神生活质量低与病程长短(或早发)、抑郁症状的存在、尼古丁依赖以及缺乏社会支持有关。
在BD患者中,即使在心境正常期其身体和精神生活质量也较低,对抑郁症状的最佳控制以及社会支持的可得性可能会提高他们的幸福感。