Koul Aarshie, Shetty A Siddharth
Department of Psychiatry, Father Muller Medical College Hospital, Mangalore, Karnataka, India.
Ind Psychiatry J. 2022 Jan-Jun;31(1):126-134. doi: 10.4103/ipj.ipj_233_20. Epub 2021 Dec 21.
Psychiatric comorbidity has been detected in one-third of bipolar patients. The illness itself may be a precipitating factor for developing substance use and anxiety disorders. Comorbid anxiety disorders with bipolar disorder (BD) are associated with decreased chances of recovery, poorer role functioning, and quality of life, and greater likelihood of suicide attempts. Hence, identifying comorbid symptoms in remitting patients has important preventive and therapeutic implications.
The aim of the study was to estimate the frequency of psychiatric comorbid symptoms in patients of bipolar affective disorder in remission and to identify its relationship with sociodemographic variables.
This is a cross-sectional study conducted in Father Muller Medical College and Hospital, Mangalore (April 2019-July 2019), which included 90 patients aged 18-50 years with BD, manic, or depressive episodes in remission for 8 weeks who were evaluated using mini international neuropsychiatric interview plus, Hamilton rating scale for depression, and young mania rating scale. Sociodemographic details were assessed by a semi-structured pro forma. The data were analyzed using frequency, Chi-square test, and -test.
Most common psychiatry comorbid symptoms seen in BD were found to be drug dependence/abuse ( = 31), second most common being alcohol dependence/abuse ( = 21), followed by suicidality ( = 8), antisocial personality, social phobia, panic disorder, and agoraphobia. Significance was found for suicidality, agoraphobia, and social phobia if the last episode was depressive and for suicidality if index episode was depressive and if age of onset was >40 years.
Psychiatric comorbidities in BD may worsen the course and prognosis of the disorder and hence, clinicians must maintain a high index of suspicion for them. Furthermore, comorbidities may need to be identified and appropriate interventions employed to prevent iatrogenic complications.
在三分之一的双相情感障碍患者中已检测到精神疾病共病。疾病本身可能是导致物质使用障碍和焦虑症的一个诱发因素。双相情感障碍（BD）合并焦虑症与康复机会减少、角色功能和生活质量较差以及自杀企图的可能性增加有关。因此，识别缓解期患者的共病症状具有重要的预防和治疗意义。
本研究的目的是评估缓解期双相情感障碍患者精神共病症状的发生率，并确定其与社会人口统计学变量的关系。
这是一项在芒格洛尔的圣心医学院和医院进行的横断面研究（2019年4月至2019年7月），研究对象包括90名年龄在18至50岁之间、患有双相情感障碍、处于躁狂或抑郁发作缓解期8周的患者，使用迷你国际神经精神访谈升级版、汉密尔顿抑郁量表和青年躁狂量表对其进行评估。通过半结构化表格评估社会人口统计学细节。使用频率、卡方检验和t检验对数据进行分析。
双相情感障碍患者中最常见的精神共病症状是药物依赖/滥用（n = 31），第二常见的是酒精依赖/滥用（n = 21），其次是自杀倾向（n = 8）、反社会人格、社交恐惧症、惊恐障碍和广场恐惧症。如果最后一次发作是抑郁发作，则自杀倾向、广场恐惧症和社交恐惧症具有统计学意义；如果首发发作是抑郁发作且发病年龄>40岁，则自杀倾向具有统计学意义。
双相情感障碍中的精神共病可能会使该疾病的病程和预后恶化，因此，临床医生必须对其保持高度怀疑。此外，可能需要识别共病并采取适当的干预措施以预防医源性并发症。
