Munoli Ravindra Neelakanthappa, Praharaj Samir Kumar, Sharma Podila Satya Venkata Narasimha
Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India.
Indian J Psychol Med. 2014 Jul;36(3):270-5. doi: 10.4103/0253-7176.135377.
Bipolar disorder is a relatively common, long-term, and disabling psychiatric illness that is associated with high levels of functional impairment, morbidity, mortality, and an increased risk of suicide. Psychiatric co-morbidity in bipolar disorder ranges from 57.3% to 74.3%, whereas medical co-morbidity varies from 2.7-70%. Indian scenario in this aspect is not clear.
The objective was to ascertain the prevalence of physical and psychiatric co-morbidities in patients attending a tertiary care center over a period of 1 year and its relationship with socio-demographic and clinical variables. One hundred and twenty-five case record files were included in the review. OPCRIT software was used for re-establishing the diagnosis of bipolar disorder, which yielded 120 cases. A semi-structured pro-forma, specifically designed for the study, was used to collect the socio-demographic and clinical details.
Co-morbid psychiatric disorders were found in 52 (43.3%) of the sample, whereas co-morbid physical illness was present in 77 (64.2%) patients. The most common psychiatric disorder associated was substance use disorder (27.5%), whereas co-morbid cardiovascular disorder was the most frequent physical diagnosis in the sample (20%).
The prevalence of co-morbid psychiatric disorders in bipolar patients was lower than that reported in western literature. It could be related to retrospective nature of study or reflect true lower prevalence rates. Also, certain disorders such as eating disorders were absent in our sample, and migraine diagnosis was very infrequent.
双相情感障碍是一种相对常见、长期且致残的精神疾病，与高水平的功能损害、发病率、死亡率以及自杀风险增加相关。双相情感障碍患者的精神共病率在57.3%至74.3%之间，而躯体共病率则在2.7%至70%之间。印度在这方面的情况尚不清楚。
目的是确定在一年时间内就诊于一家三级医疗中心的患者中躯体和精神共病的患病率及其与社会人口学和临床变量的关系。本综述纳入了125份病例记录档案。使用OPCRIT软件重新确立双相情感障碍的诊断，最终得到120例病例。采用专门为该研究设计的半结构化表格收集社会人口学和临床细节。
样本中有52例（43.3%）存在共病精神障碍，77例（64.2%）患者存在共病躯体疾病。最常见的相关精神障碍是物质使用障碍（27.5%），而共病心血管疾病是样本中最常见的躯体诊断（20%）。
双相情感障碍患者中共病精神障碍的患病率低于西方文献报道。这可能与研究的回顾性性质有关，或者反映了实际较低的患病率。此外，我们的样本中不存在某些疾病，如饮食失调，偏头痛的诊断也非常少见。
