Patel Rikinkumar S, Virani Sanya, Saeed Hina, Nimmagadda Sai, Talukdar Jupi, Youssef Nagy A
Department of Psychiatry, Griffin Memorial Hospital, 900 E Main St, Norman, OK 73071, USA.
Department of Psychiatry, Maimonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219, USA.
Brain Sci. 2018 Sep 1;8(9):168. doi: 10.3390/brainsci8090168.
Past studies have evaluated the association of various comorbidities with bipolar disorder. This study analyzes differences in the prevalence and association of medical and psychiatric comorbidities in bipolar patients by gender.
A retrospective analysis was conducted using the Nationwide Inpatient Sample (2010⁻2014). Using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes, we narrowed the study population to comprise those with a primary diagnosis of bipolar disorder and then obtained information about comorbidities. The differences in comorbidities by gender were quantified using chi-square tests and the logistic regression model (odds ratio (OR)).
Hypertension (20.5%), asthma (12.5%) and hypothyroidism (8.1%) were the top medical comorbidities found in bipolar patients. Migraine and hypothyroidism were seen three times higher in females (OR = 3.074 and OR = 3.001; respectively). Females with bipolar disorder had higher odds of comorbid inflammatory disorders like asthma (OR = 1.755), Crohn's disease (OR = 1.197) and multiple sclerosis (OR = 2.440) compared to males. Females had a two-fold higher likelihood of comorbid post-traumatic stress disorder (PTSD) (OR = 2.253) followed by personality disorders (OR = 1.692) and anxiety disorders (OR = 1.663) compared to males.
Women with bipolar disorder have a much higher medical comorbidity burden than men and may highly benefit from an integrated team of physicians to manage their condition and improve their health-related quality of life.
既往研究评估了各种合并症与双相情感障碍的关联。本研究分析了双相情感障碍患者中，按性别划分的医学和精神科合并症在患病率及关联方面的差异。
利用全国住院患者样本（2010 - 2014年）进行回顾性分析。使用国际疾病分类第九版临床修订本（ICD - 9 - CM）编码，我们将研究人群限定为那些主要诊断为双相情感障碍的患者，然后获取有关合并症的信息。使用卡方检验和逻辑回归模型（比值比（OR））对按性别划分的合并症差异进行量化。
高血压（20.5%）、哮喘（12.5%）和甲状腺功能减退（8.1%）是双相情感障碍患者中最常见的医学合并症。女性患偏头痛和甲状腺功能减退的几率是男性的三倍（分别为OR = 3.074和OR = 3.001）。与男性相比，双相情感障碍女性患合并症如哮喘（OR = 1.755）、克罗恩病（OR = 1.197）和多发性硬化症（OR = 2.440）的几率更高。与男性相比，女性患合并创伤后应激障碍（PTSD）（OR = 2.253）、其次是人格障碍（OR = 1.692）和焦虑症（OR = 1.663）的可能性高出两倍。
双相情感障碍女性的医学合并症负担比男性高得多，可能会从综合医生团队管理其病情并改善其健康相关生活质量中受益匪浅。
