Department of Psychiatry, University of Texas Health Science Center, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA.
Psychiatr Serv. 2010 Feb;61(2):164-72. doi: 10.1176/ps.2010.61.2.164.
Few studies have compared treatment outcomes of African-American, Hispanic, and non-Hispanic white patients with bipolar disorder. The U.S. Systematic Treatment Enhancement Program for Bipolar Disorder compared one-year outcomes for bipolar I or II disorder from each of these racial-ethnic groups.
African Americans (N=155) were retrospectively compared with a matched group of non-Hispanic whites (N=729), and Hispanics (N=152) were compared with a separate matched group of non-Hispanic whites (N=822). Response and recovery outcomes were examined. Survival analysis was used to compare time to treatment response for depression (Montgomery-Asberg Depression Rating Scale) and mania (Young Mania Rating Scale) as well as global assessment of functioning (Global Assessment of Functioning).
For manic and depressive symptoms, time to response and proportion of responders were similar across groups. Over the study year the proportion of days well was similar across groups. A smaller proportion of African Americans met criteria for improved global functioning. Depression response among African Americans with psychotic symptoms was slower than the response among African Americans without psychotic symptoms and among non-Hispanic whites with or without psychotic symptoms. No differences between Hispanics and non-Hispanic whites in response times and recovery were observed.
Results are consistent with U.S. clinical trials for other psychiatric disorders, which have reported similar outcomes for ratings of primary symptoms. Baseline psychotic symptoms are likely a significant contributor when African Americans with bipolar disorder are slow to recover. These results may be less generalizable to uninsured patients.
很少有研究比较过非裔美国人、西班牙裔和非西班牙裔白人的双相情感障碍患者的治疗结果。美国双相情感障碍系统治疗强化计划比较了来自这些种族群体的每一组 1 年的双相 I 或 II 障碍结果。
将 155 名非裔美国人（N=155）与一组匹配的非西班牙裔白人（N=729）进行回顾性比较，将 152 名西班牙裔（N=152）与另一组匹配的非西班牙裔白人（N=822）进行比较。检查了反应和恢复结果。使用生存分析比较抑郁（蒙哥马利-阿斯伯格抑郁评定量表）和躁狂（杨躁狂评定量表）以及总体功能评估（总体功能评估）的治疗反应时间和治疗反应者比例。
在躁狂和抑郁症状方面，反应时间和反应者比例在各组之间相似。在研究的一年中，各组的好转天数比例相似。改善的总体功能标准符合率较低。有精神病症状的非裔美国人的抑郁反应比没有精神病症状的非裔美国人和有或没有精神病症状的非西班牙裔白人的反应慢。在反应时间和恢复方面，西班牙裔人与非西班牙裔白人之间没有差异。
这些结果与美国其他精神科疾病的临床试验结果一致，这些试验报告了主要症状评分的相似结果。当双相情感障碍的非裔美国人恢复缓慢时，基线精神病症状可能是一个重要的促成因素。这些结果可能不太适用于没有保险的患者。
