Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan; The Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan.
The Japanese Association of Neuro-Psychiatric Clinics, Tokyo, Japan.
J Psychiatr Res. 2022 Jul;151:683-692. doi: 10.1016/j.jpsychires.2022.05.028. Epub 2022 May 24.
There is limited evidence regarding predictors of long-term clinical outcomes in patients with bipolar disorder (BD). The objective of this study was to describe 3-year clinical outcomes and identify their predictors from participants in the multicenter treatment survey for BD in psychiatric outpatient clinics (MUSUBI).
The MUSUBI was a naturalistic study investigating patients with BD in real-world clinical practice. Our study extracted data regarding 1647 outpatients with BD from 2016, 2017, and 2019 as baseline, 1-year, and 3-year assessments. As clinical outcomes, we assessed the presence of time ill (depressive and manic) during the 1 year prior to the 3-year assessment and durable remission (53 weeks or more) prior to the 3-year assessment.
Participants with durable remission prior to the 3-year assessment had significant associations with diagnosis of a personality disorder and duration of continuous remission at baseline. Regarding the presence of depressive symptoms during the 1 year prior to the 3-year assessment, work status, Global Assessment of Functioning (GAF) scores, suicidal ideation, and duration of continuous remission at baseline had significant associations with this outcome.
At the 3-year assessment, 19.3% of participants (318/1647) achieved durable remission, while 47.5% of them (782/1647) were not remitted. Our findings can help clinicians predict the illness course of BD by understanding demographic and clinical characteristics.
目前关于双相情感障碍（BD）患者长期临床结局的预测因素的证据有限。本研究的目的是描述 3 年的临床结局，并从精神科门诊多中心 BD 治疗调查（MUSUBI）的参与者中确定其预测因素。
MUSUBI 是一项在真实临床环境中调查 BD 患者的自然主义研究。我们的研究从 2016、2017 和 2019 年的基线、1 年和 3 年评估中提取了 1647 名 BD 门诊患者的数据。作为临床结局，我们评估了在 3 年评估前的 1 年内时间病（抑郁和躁狂）的存在情况以及在 3 年评估前的持久缓解（53 周或以上）。
在 3 年评估前达到持久缓解的参与者与人格障碍的诊断和基线时连续缓解的持续时间有显著关联。关于在 3 年评估前的 1 年内抑郁症状的存在，工作状态、总体功能评估（GAF）评分、自杀意念和基线时连续缓解的持续时间与该结局有显著关联。
在 3 年评估时，19.3%（318/1647）的参与者达到持久缓解，而 47.5%（782/1647）的参与者未缓解。我们的发现可以帮助临床医生通过了解人口统计学和临床特征来预测 BD 的疾病进程。
