Lagerberg Trine Vik, Larsson Sara, Sundet Kjetil, Hansen Charlotte B, Hellvin Tone, Andreassen Ole A, Melle Ingrid
Psychosis Research Unit, Division of Mental Health and Addiction, Department of Research and Development, Oslo University Hospital, Oslo, Norway.
J Nerv Ment Dis. 2010 Sep;198(9):628-33. doi: 10.1097/NMD.0b013e3181ef3ef4.
The aim of the present study was to investigate the relationship between treatment delay and excessive substance use. A total of 151 bipolar disorder (BD) I and II patients were consecutively recruited from in- and outpatient psychiatric units, and categorized as primary or secondary BD (without or with antecedent excessive substance use). Predictors of treatment delay among all patients, and predictors of subsequent excessive substance use among primary BD patients, were investigated with logistic regression analyses. The median treatment delay was 2.0 years (IQR 14.0). The risk of long treatment delays was increased in patients with BD II disorder, no lifetime psychosis, a higher age at first contact with specialized psychiatric services, primary BD, and excessive substance use. In primary BD, the risk for developing excessive substance use was increased in males, in patients with shorter education and longer treatment delays. Patients with antecedent excessive substance use had reduced risk of long treatment delays. The risk of developing excessive substance use after BD onset increased with longer treatment delays.
本研究的目的是调查治疗延迟与物质使用过量之间的关系。从住院和门诊精神科连续招募了总共151例双相I型和II型障碍（BD）患者，并将其分为原发性或继发性BD（无或有既往物质使用过量）。通过逻辑回归分析研究了所有患者中治疗延迟的预测因素以及原发性BD患者中随后物质使用过量的预测因素。治疗延迟的中位数为2.0年（四分位间距为14.0）。双相II型障碍、无终生精神病、首次接触专科精神科服务时年龄较大、原发性BD和物质使用过量的患者出现长期治疗延迟的风险增加。在原发性BD中，男性、受教育时间较短和治疗延迟较长的患者出现物质使用过量的风险增加。既往有物质使用过量的患者出现长期治疗延迟的风险降低。BD发病后出现物质使用过量的风险随着治疗延迟时间的延长而增加。
