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双相障碍的生活质量和临床结局:一项 8 年的纵向研究。

Quality of life and clinical outcomes in bipolar disorder: An 8-year longitudinal study.

机构信息

Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil.

Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil.

出版信息

J Affect Disord. 2021 Jan 1;278:239-243. doi: 10.1016/j.jad.2020.09.061. Epub 2020 Sep 15.

Abstract

OBJECTIVES

This longitudinal study examined the relationship of Quality of Life (QOL) throughout an 8-year follow-up period with baseline and longitudinal clinical variables indicative of outcome in patients with Bipolar Disorder (BD).

METHODS

36 participants, ages 18-70, were recruited from the Bipolar Disorder Research Program (PROMAN) outpatient clinic. Participants completed the WHOQOL-BREF questionnaire in 2009 (baseline), 2015 (6-years) and 2017 (8-years), with high scores being associated with better quality of life. Baseline clinical variables were collected through the Structured Clinical Interview for DSM-IV (SCID-IV) and a structured baseline interview for demographic and clinical assessment. Longitudinal clinical variables were collected through medical records, including mood charts and mood symptoms scales.

RESULTS

The results suggest that the QoL, as measured by the WHOQOL-BREF scale, is negatively affected by depressive episodes and is rather stable throughout the course of patients diagnosed with BD. In our study, all three scores were negatively correlated to depressive episodes, and one WHOQOL-BREF score was positively correlated to manic episodes, suggesting that higher scores, both at baseline and throughout the course of the disorder, may be associated to a higher occurrence of manic episodes, while lower QoL scores may be predictive of a higher occurrence of depressive episodes. Also, all three scores revealed significant positive correlations between themselves, suggesting QoL, as measured by the WHOQOL-BREF, remained constant throughout the 8-year observed period. Finally, patients presenting Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and substance abuse comorbidities revealed consistent lower WHOQOL-BREF scores, suggesting that these comorbidities may be an important predictor of QoL in BD patients.

摘要

目的

本纵向研究考察了在 8 年随访期间,生活质量(QOL)与基线和纵向临床变量之间的关系,这些临床变量提示双相情感障碍(BD)患者的结局。

方法

36 名年龄在 18-70 岁的参与者从双相情感障碍研究计划(PROMAN)门诊招募。参与者在 2009 年(基线)、2015 年(6 年)和 2017 年(8 年)完成了世界卫生组织生活质量测定量表简表(WHOQOL-BREF)问卷,高分与更好的生活质量相关。基线临床变量通过 DSM-IV 结构临床访谈(SCID-IV)和用于人口统计学和临床评估的结构化基线访谈收集。纵向临床变量通过病历收集,包括情绪图表和情绪症状量表。

结果

结果表明,WHOQOL-BREF 量表测量的生活质量受到抑郁发作的负面影响,并且在诊断为 BD 的患者的整个病程中相对稳定。在我们的研究中,所有三个评分都与抑郁发作呈负相关,一个 WHOQOL-BREF 评分与躁狂发作呈正相关,这表明在基线和整个疾病过程中,较高的评分可能与较高的躁狂发作发生率相关,而较低的 QoL 评分可能预示着更高的抑郁发作发生率。此外,所有三个评分之间也存在显著的正相关,这表明 WHOQOL-BREF 测量的生活质量在 8 年的观察期间保持不变。最后,患有强迫症(OCD)、创伤后应激障碍(PTSD)和物质滥用共病的患者表现出持续较低的 WHOQOL-BREF 评分,这表明这些共病可能是 BD 患者生活质量的一个重要预测因素。

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