Division of Preventive Medicine, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA.
Psychiatr Serv. 2011 Oct;62(10):1152-8. doi: 10.1176/ps.62.10.pss6210_1152.
From 40% to 65% of patients with bipolar disorder are estimated to have diagnoses of one or more comorbid conditions. The purpose of this study was to identify comorbid disorders and compare their prevalence in hospitalizations of persons with or without bipolar disorder.
Data from the 1979-2006 National Hospital Discharge Survey (NHDS) were analyzed to examine temporal trends in the proportional morbidity of bipolar disorder, demographic characteristics, and the most frequent comorbid conditions in hospitalizations of patients with or without bipolar disorder. Among discharges of patients ages 13-64, the conditions of those with a primary diagnosis of bipolar disorder (N=27,054) were compared with those with other primary diagnoses (N=2,325,247). Proportional morbidity ratios (PMRs) were calculated.
There was an average 10% (p<.001) increase per year in the proportion of discharges with bipolar disorder. Proportions of discharge records that noted bipolar disorder were higher among females and whites and were highest among persons ages 13-19 and those from the Northeast. Discharge records noting a primary diagnosis of bipolar disorder showed higher proportions of most psychiatric and some general medical conditions, including acquired hypothyroidism (proportional morbidity ratio=2.6), viral hepatitis (1.6), obesity (1.4), and various diseases of the skin and subcutaneous tissue (range 2.6-4.2) and of the nervous (1.4-3.8), respiratory (1.4-2.3), and musculoskeletal (1.2-1.9) systems.
Patients with bipolar disorder have an increased illness burden from many psychiatric and general medical conditions. Knowledge of the most prevalent comorbid conditions and methods for their prevention, early diagnosis, and treatment are critical in improving the prognosis of patients with bipolar disorder.
据估计，40%至 65%的双相情感障碍患者存在一种或多种共病。本研究旨在确定共病障碍，并比较伴有和不伴有双相情感障碍的住院患者的患病率。
分析 1979 年至 2006 年全国医院出院调查（NHDS）的数据，以检查双相情感障碍的比例发病率、人口统计学特征以及伴有和不伴有双相情感障碍的住院患者最常见的共病情况的时间趋势。在年龄为 13-64 岁的出院患者中，将双相情感障碍的主要诊断患者（N=27054）的病情与其他主要诊断患者（N=2325247）进行比较。计算比例发病率比（PMRs）。
每年双相情感障碍出院患者的比例平均增加 10%（p<.001）。女性和白人的双相情感障碍出院记录比例较高，13-19 岁和东北地区的患者比例最高。记录有主要诊断为双相情感障碍的出院记录显示，大多数精神疾病和一些一般医疗状况的比例较高，包括获得性甲状腺功能减退症（比例发病率比=2.6）、病毒性肝炎（1.6）、肥胖症（1.4）、以及各种皮肤和皮下组织疾病（范围为 2.6-4.2）和神经（1.4-3.8）、呼吸（1.4-2.3）和肌肉骨骼系统疾病（1.2-1.9）。
双相情感障碍患者患有多种精神和一般医疗状况，疾病负担加重。了解最常见的共病情况及其预防、早期诊断和治疗方法对于改善双相情感障碍患者的预后至关重要。
