CMME, Centre hospitalier Sainte-Anne, Paris, France.
J Affect Disord. 2011 May;130(3):492-5. doi: 10.1016/j.jad.2010.10.037. Epub 2010 Nov 24.
Recently, an unexpected 3-fold higher screen positive rate for bipolar disorder was found among low-income American patients who were seeking primary care at an urban general medicine clinic as compared with the general population of the United States. The social health system in France is characterized by its open access, where most bipolar patients ask for care and where the major problem is diagnosis by the general practitioner (GP). Therefore, we investigated the prevalence of bipolar disorder among patients attending GP offices in France.
This observational, single visit survey was performed among 10,265 patients (47.2±18.0 years old, 40% males) attending primary care in 95 GP offices in France. The participating GP made available an MDQ-French version questionnaire to all patients aged 15 years and over, going to his office during a full week, independently of the reason for medical consulting. In addition to the MDQ-French version questionnaire, patients answered items concerning sex, age, professional situation and marital state.
One thousand twenty-five (1025) patients did not complete the questionnaire and were excluded from the analysis. Of the 9240 analyzed questionnaires, 8.3% were classified as MDQ positives (MDQ+). MDQ+ patients were significantly younger (41.6 years versus 46.6 years for MDQ- patients, p<0.0001), more frequently divorced or separated (19.2% versus 8.6%, p<0.0001) and more frequently unemployed (15.2% versus 6.4%, p<0.0001). The gender distribution was not significantly different between the two groups.
The prevalence of receiving positive screening results for bipolar disease in 9240 patients consulting 95 randomly selected french general practitioners was 8.3%, as assessed by the MDQ questionnaire. This is a similar and unexpected high value as that reported for low-income american patients (9.8%). Besides low socioeconomic status, other factors should explain the high screen positive rate for bipolar disorder in patients attending primary care.
最近，在美国一家城市综合医学诊所寻求初级保健的低收入美国患者中，双相情感障碍的筛查阳性率出人意料地高出 3 倍，而这一比例高于美国普通人群。法国的社会健康体系以开放获取为特点，大多数双相情感障碍患者在此寻求治疗，而主要问题是由全科医生（GP）进行诊断。因此，我们调查了法国全科医生办公室就诊患者中双相情感障碍的患病率。
这是一项观察性、单访调查，共纳入 10265 名（47.2±18.0 岁，40%为男性）在法国 95 家全科医生办公室就诊的初级保健患者。参与调查的全科医生向所有年龄在 15 岁及以上、在一周内到其办公室就诊的患者提供了一份经过法国验证的 MDQ 问卷，就诊原因不限。除了 MDQ-法国验证版问卷外，患者还回答了有关性别、年龄、职业状况和婚姻状况的项目。
1025 名患者未完成问卷，被排除在分析之外。在分析的 9240 份问卷中，8.3%被归类为 MDQ 阳性（MDQ+）。MDQ+患者明显更年轻（41.6 岁比 MDQ-患者 46.6 岁，p<0.0001），离婚或分居的比例更高（19.2%比 8.6%，p<0.0001），失业的比例更高（15.2%比 6.4%，p<0.0001）。两组间的性别分布无显著差异。
在 9240 名接受随机选择的法国全科医生就诊的患者中，使用 MDQ 问卷评估，双相情感障碍的阳性筛查结果为 8.3%。这一比例与低收入美国患者（9.8%）的报告相似，令人意外地较高。除了较低的社会经济地位外，其他因素也应解释初级保健就诊患者双相情感障碍筛查阳性率较高的原因。
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