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双相情感障碍 I 型与 II 型患者的社会人口学和临床特征:一项全国性意大利研究。

Socio-demographic and clinical characterization of patients with Bipolar Disorder I vs II: a Nationwide Italian Study.

机构信息

Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.

Unit of Biostatistics and Biomathematics, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2018 Mar;268(2):169-177. doi: 10.1007/s00406-017-0791-0. Epub 2017 Apr 1.

DOI:10.1007/s00406-017-0791-0
PMID:28365865
Abstract

Bipolar disorders (BDs) are prevalent, comorbid and disabling conditions, associated with the highest suicide risk among psychiatric illnesses. In the last few years, new efforts to better characterize the socio-demographic and clinical profiles of BD type I vs II have been documented by several reports, with novel and insightful findings in the field. The present multicenter study aimed to provide a comprehensive and reliable representation of the Italian reality, through the analysis of the largest national sample of bipolar patients collected so far. A total of 1500 patients (BD I n = 963 and BD II n = 537) from different psychiatric departments, participating in the Italian Chapter of the "International Society of Bipolar Disorders" (ISBD), were assessed and divided into two groups on the basis of their diagnostic subtype, and different socio-demographic and clinical variables were compared between the two subgroups. Chi-squared tests for categorical variables and t tests for continuous variables were performed for group comparison. Furthermore, a multivariable logistic regression was performed, considering diagnostic bipolar subtype (type I or II) as dependent variable, and socio-demographic/clinical characteristics as independent variables. BD I vs II patients showed an overall less favorable socio-demographic and clinical profile. In addition, the multivariable logistic regression showed that BD II vs BD I was predicted by the absence of lifetime suicide attempts (OR = 1.58, p = 0.01), a later age of diagnosis (OR = 1.03, p < 0.01), less hypomanic episodes in the last year (OR = 2.29, p < 0.0001) and absence of psycho-educational interventions in the last year (OR = 0.51, p < 0.01). BD I and II patients were found to significantly differ in relation to specific clinical variables, which should be considered within updated diagnostic-therapeutic algorithms.

摘要

双相情感障碍(BDs)是一种普遍存在、合并存在且使人丧失能力的疾病,与精神疾病中最高的自杀风险相关。在过去的几年中,有几项报告记录了新的努力,以更好地描述 I 型和 II 型双相情感障碍的社会人口学和临床特征,该领域有新的和有见地的发现。本项多中心研究旨在通过分析迄今为止收集到的最大的意大利双相情感障碍患者样本,提供对意大利现实情况的全面和可靠的描述。来自不同精神科部门的 1500 名患者(BD I 组 n=963,BD II 组 n=537)参加了“国际双相情感障碍协会”(ISBD)的意大利分会,根据他们的诊断亚型分为两组,并比较了两组之间的不同社会人口学和临床变量。对于分类变量进行卡方检验,对于连续变量进行 t 检验以进行组间比较。此外,进行了多变量逻辑回归分析,将诊断性双相情感障碍亚型(I 型或 II 型)作为因变量,将社会人口学/临床特征作为自变量。BD I 与 II 患者的整体社会人口学和临床特征较差。此外,多变量逻辑回归表明,BD II 较 BD I 的预测因素为无终生自杀企图(OR=1.58,p=0.01)、诊断年龄较晚(OR=1.03,p<0.01)、去年轻躁狂发作次数较少(OR=2.29,p<0.0001)和去年无心理教育干预(OR=0.51,p<0.01)。发现 BD I 和 II 患者在特定临床变量方面存在显著差异,这在更新的诊断-治疗算法中应予以考虑。

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