Perron Brian E, Howard Matthew O, Nienhuis Jenna K, Bauer Mark S, Woodward Amanda Toler, Kilbourne Amy M
University of Michigan, Ann Arbor, MI 48109, USA.
J Clin Psychiatry. 2009 Oct;70(10):1407-15. doi: 10.4088/JCP.08m04586yel.
To examine the prevalence and burden of general medical conditions (GMCs) among a nationally representative sample of adults with bipolar I disorder.
Data for this study were derived from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093), which included US adults aged 18 years and older. This study focused on the subsample of adults with DSM-IV-diagnosed bipolar I disorder (n = 1,548). The past-year prevalence of 11 GMCs was examined. Associations between GMCs, bipolar I disorder, and disability measures (12-Item Short-Form Health Survey) were tested using multivariate regression analyses.
Approximately 32.4% of adults with bipolar I disorder had 1 or more GMCs. In the general population, diagnosis with bipolar I disorder was a significant risk factor for 7 of 11 GMCs in adjusted analyses. Among adults with bipolar I disorder, those with 1 or more GMCs evidenced significantly greater disability across all disability measures compared to those without a GMC. Individual GMCs were significantly associated with physical, mental, and psychosocial disability in adjusted analyses and predicted specific patterns of disability.
GMCs were found disproportionately among persons with bipolar I disorder and associated with significant impairments in health and psychosocial functioning. Health care providers should screen for and treat GMCs in service populations including persons with bipolar disorder, given the heightened rates of morbidity, mortality, and disability that attend untreated GMCs in this client group. Integrated and collaborative treatment approaches could significantly improve overall functioning and quality of life for persons with this treatable disorder.
在全国具有代表性的I型双相情感障碍成年样本中，研究常见躯体疾病（GMCs）的患病率及负担情况。
本研究数据来源于2001 - 2002年全国酒精及相关疾病流行病学调查（N = 43,093），该调查涵盖了18岁及以上的美国成年人。本研究聚焦于被诊断为DSM - IV标准下I型双相情感障碍的成年子样本（n = 1,548）。研究了11种常见躯体疾病在过去一年中的患病率。使用多变量回归分析测试了常见躯体疾病、I型双相情感障碍与残疾测量指标（12项简短健康调查问卷）之间的关联。
约32.4%的I型双相情感障碍成年人患有1种或更多种常见躯体疾病。在总体人群中，经校正分析，I型双相情感障碍诊断是11种常见躯体疾病中7种疾病的显著危险因素。在患有I型双相情感障碍的成年人中，与未患常见躯体疾病的人相比，患有1种或更多种常见躯体疾病的人在所有残疾测量指标上的残疾程度明显更高。经校正分析，个体常见躯体疾病与身体、心理和社会心理残疾显著相关，并预测了特定的残疾模式。
在I型双相情感障碍患者中，常见躯体疾病的发生率不成比例，且与健康和社会心理功能的显著损害相关。鉴于该患者群体中未经治疗的常见躯体疾病会导致更高的发病率、死亡率和残疾率，医疗保健提供者应在包括双相情感障碍患者在内的服务人群中筛查和治疗常见躯体疾病。综合和协作的治疗方法可显著改善这种可治疗疾病患者的整体功能和生活质量。
