Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
J Affect Disord. 2020 May 1;268:150-157. doi: 10.1016/j.jad.2020.03.018. Epub 2020 Mar 5.
The HOPE-BD was a naturalistic study established to follow individuals in Canada seeking treatment for bipolar disorder (BD). The study aimed to examine the course of BD and describe how clinical and sociodemographic factors are associated with outcomes.
Individuals with BD had their clinical data recorded at enrolment and were naturalistically treated. Participant were followed for up to four years, and visits occurred at least once every three months. We investigated the longitudinal outcomes with logistic, Cox, and quantile regressions.
Among the 354 participants, 57.3% had BD type I. Depression as first episode, younger ages at onset and older ages of the first professional help predicted longer delays in correct diagnosis. Among the symptomatic patients at baseline, the median time to remission was 10.9 months. Comorbid alcohol use disorder and the severity of baseline depressive symptoms predicted longer times to remission. Among the euthymic participants, the median time to recurrence was 14.5 months. History of anxiety disorder and younger ages at onset predicted shorter times to recurrence. Baseline depression scores predicted recurrence in euthymic patients.
We did not investigate the predictors of each polarity. Our findings may not apply to individuals followed in non-specialised outpatient services.
Our study reinforces the necessity of early diagnosis and interventions, as well as the importance of treating depressive symptoms and comorbidities.
HOPE-BD 是一项自然主义研究，旨在随访在加拿大寻求双相情感障碍（BD）治疗的个体。该研究旨在检查 BD 的病程，并描述临床和社会人口因素与结局的关系。
BD 患者在入组时记录其临床数据，并进行自然治疗。参与者随访时间长达四年，每三个月至少随访一次。我们使用逻辑回归、Cox 回归和分位数回归来研究纵向结局。
在 354 名参与者中，57.3%为 BD Ⅰ型。首次发作时为抑郁、发病年龄较小和首次寻求专业帮助的年龄较大，预测正确诊断的延迟时间较长。在基线时有症状的患者中，缓解的中位数时间为 10.9 个月。共病酒精使用障碍和基线抑郁症状的严重程度预测缓解时间较长。在心境良好的参与者中，复发的中位数时间为 14.5 个月。焦虑障碍史和发病年龄较小预测复发时间较短。基线抑郁评分预测心境良好患者的复发。
我们没有研究每个极性的预测因素。我们的研究结果可能不适用于在非专科门诊服务中随访的个体。
我们的研究强调了早期诊断和干预的必要性，以及治疗抑郁症状和共病的重要性。
