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双相 I 型障碍(躁狂发作)未治疗疾病持续时间对埃及人群临床结局和社会经济负担的影响。

Impact of duration of untreated illness in bipolar I disorder (manic episodes) on clinical outcome, socioecnomic burden in Egyptian population.

作者信息

Ahmed Gellan K, Elbeh Khalid, Khalifa Hossam, Samaan Maggi Raoof

机构信息

Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.

Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

Psychiatry Res. 2021 Feb;296:113659. doi: 10.1016/j.psychres.2020.113659. Epub 2020 Dec 23.

Abstract

INTRODUCTION

Bipolar disorder (BD) is a serious and chronic mental illness that may result in disability. We evaluated effect of the duration of untreated of bipolar (DUB) (manic episodes) on clinical outcomes, including episode severity, residual symptoms, duration of hospitalization, and suicide attempts, and on socioeconomic status of patients.

METHODS

A total of 216 participants who had bipolar I disorder (manic state) recruited from November 2017-December 2019 from an inpatient psychiatric unit. Patients divided into 2 groups based on DUB: Group A, with DUB < 4 months; and Group B, with DUB ≥4 months. All participants had evaluation for demographic and clinical features, Socioeconomic scale, Young mania rating scale (YMRS) at admission and discharge.

RESULTS

Group A participants were more often male, urban residents, married, literate and educated, professionally employed. Group A had a younger age of onset, less duration of illness, less frequency of episode, less suicide attempts, less duration in hospital, high mean of socioeconomic, lower mean of YMRS at admission and discharge in compared to Group B.

CONCLUSION

A longer DUB (manic episodes)was associated with negative clinical outcomes (more frequent episode, more symptoms severity, longer hospital admission, more suicide severity, more residual symptoms) and low socioeconomic state of patients with BDI (manic episodes).

摘要

引言

双相情感障碍(BD)是一种严重的慢性精神疾病,可能导致残疾。我们评估了双相情感障碍(躁狂发作)未治疗期(DUB)对临床结局的影响,包括发作严重程度、残留症状、住院时间和自杀企图,以及对患者社会经济状况的影响。

方法

2017年11月至2019年12月从一家住院精神科病房招募了216名患有双相I型障碍(躁狂状态)的参与者。根据DUB将患者分为两组:A组,DUB<4个月;B组,DUB≥4个月。所有参与者在入院和出院时均接受了人口统计学和临床特征、社会经济量表、青年躁狂评定量表(YMRS)的评估。

结果

A组参与者男性更多,为城市居民,已婚,有文化且受过教育,有职业。与B组相比,A组发病年龄更小,病程更短,发作频率更低,自杀企图更少,住院时间更短,社会经济平均水平更高,入院和出院时YMRS平均水平更低。

结论

较长的DUB(躁狂发作)与双相I型障碍(躁狂发作)患者的不良临床结局(发作更频繁、症状更严重、住院时间更长、自杀严重程度更高、残留症状更多)和低社会经济状态相关。

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