University of Cagliari, Italy, Cagliari, Italy.
BMC Psychiatry. 2012 May 30;12:52. doi: 10.1186/1471-244X-12-52.
The aim of this study was to determine the risk for Bipolar Disorder (BD) in Wilson's disease (WD) and to measure the impaired Quality of Life (QL) in BD with WD using standardized psychiatric diagnostic tools and a case control design.
This was a case control study. The cases were 23 consecutive patients with WD treated at the University Hospital in Cagliari, Italy, and the controls were 92 sex- and age-matched subjects with no diagnosis of WD who were randomly selected from a database used previously for an epidemiological study. Psychiatric diagnoses according to DSM-IV criteria were determined by physicians using structured interview tools (ANTAS-SCID). QL was measured by means of SF-12.
Compared to controls, WD patients had lower scores on the SF-12 and higher lifetime prevalence of DSM-IV major depressive disorders (OR = 5.7, 95% CI 2.4-17.3) and bipolar disorders (OR = 12.9, 95% CI 3.6-46.3). BD was associated with lower SF-12 in WD patients.
This study was the first to show an association between BD and WD using standardized diagnostic tools and a case control design. Reports in the literature about increased schizophrenia-like psychosis in WD and a lack of association with bipolar disorders may thus have been based on a more inclusive diagnosis of schizophrenia in the past. Our findings may explain the frequent reports of loss of emotional control, hyperactivity, loss of sexual inhibition, and irritability in WD patients. This study was limited by a small sample size.
本研究旨在确定肝豆状核变性（WD）患者发生双相障碍（BD）的风险，并使用标准化精神科诊断工具和病例对照设计来衡量 WD 合并 BD 患者的生活质量（QL）受损情况。
这是一项病例对照研究。病例为意大利卡利亚里大学医院收治的 23 例连续 WD 患者，对照组为 92 名性别和年龄匹配、无 WD 诊断的受试者，他们是从以前用于流行病学研究的数据库中随机选择的。精神科诊断根据 DSM-IV 标准，由医生使用结构化访谈工具（ANTAS-SCID）确定。QL 通过 SF-12 进行测量。
与对照组相比，WD 患者的 SF-12 评分较低，DSM-IV 重性抑郁障碍（OR=5.7，95%CI 2.4-17.3）和双相障碍（OR=12.9，95%CI 3.6-46.3）的终生患病率较高。BD 与 WD 患者的 SF-12 较低有关。
本研究首次使用标准化诊断工具和病例对照设计，证明 BD 与 WD 之间存在关联。文献中关于 WD 中精神分裂样精神病发病率增加而与双相障碍无关的报道可能是过去对精神分裂症的诊断更为广泛所致。我们的发现可以解释 WD 患者经常出现的情绪控制丧失、多动、性抑制丧失和易怒等症状。本研究受到样本量小的限制。
