Bolton Sorcha, Joyce Dan W, Gordon-Smith Katherine, Jones Lisa, Jones Ian, Geddes John, Saunders Kate E A
Department of Psychiatry, University of Oxford, Warneford Hospital, UK.
Department of Psychiatry, University of Oxford, Warneford Hospital, UK; and Oxford Health NHS Foundation Trust, Warneford Hospital, UK.
BJPsych Open. 2022 Jul 18;8(4):e133. doi: 10.1192/bjo.2022.536.
Bipolar disorder is a chronic and severe mental health disorder. Early stratification of individuals into subgroups based on age at onset (AAO) has the potential to inform diagnosis and early intervention. Yet, the psychosocial predictors associated with AAO are unknown.
We aim to identify psychosocial factors associated with bipolar disorder AAO.
Using data from the Bipolar Disorder Research Network UK, we employed least absolute shrinkage and selection operator regression to identify psychosocial factors associated with bipolar disorder AAO. Twenty-eight factors were entered into our model, with AAO as our outcome measure.
We included 1022 participants with bipolar disorder (μ = 23.0, s.d. ± 9.86) in our model. Six variables predicted an earlier AAO: childhood abuse (β = -0.2855), regular cannabis use in the year before onset (β = -0.2765), death of a close family friend or relative in the 6 months before onset (β = -0.2435), family history of suicide (β = -0.1385), schizotypal personality traits (β = -0.1055) and irritable temperament (β = -0.0685). Five predicted a later AAO: the average number of alcohol units consumed per week in the year before onset (β = 0.1385); birth of a child in the 6 months before onset (β = 0.2755); death of parent, partner, child or sibling in the 6 months before onset (β = 0.3125); seeking work without success for 1 month or more in the 6 months before onset (β = 0.3505) and a major financial crisis in the 6 months before onset (β = 0.4575).
The identified predictor variables have the potential to help stratify high-risk individuals into likely AAO groups, to inform treatment provision and early intervention.
双相情感障碍是一种慢性且严重的精神健康障碍。根据发病年龄（AAO）将个体早期分层为不同亚组，有可能为诊断和早期干预提供依据。然而，与AAO相关的社会心理预测因素尚不清楚。
我们旨在确定与双相情感障碍AAO相关的社会心理因素。
利用英国双相情感障碍研究网络的数据，我们采用最小绝对收缩和选择算子回归来确定与双相情感障碍AAO相关的社会心理因素。28个因素被纳入我们的模型，以AAO作为我们的结果指标。
我们的模型纳入了1022名双相情感障碍患者（均值 = 23.0，标准差±9.86）。六个变量预测了更早的AAO：童年期受虐（β = -0.2855）、发病前一年经常使用大麻（β = -0.2765）、发病前6个月亲密的家庭朋友或亲属死亡（β = -0.2435）、自杀家族史（β = -0.1385）、分裂型人格特质（β = -0.1055）和易激惹气质（β = -0.0685）。五个变量预测了更晚的AAO：发病前一年每周平均饮酒单位数（β = 0.1385）；发病前6个月孩子出生（β = 0.2755）；发病前6个月父母、伴侣、孩子或兄弟姐妹死亡（β = 0.3125）；发病前6个月求职1个月或更长时间未成功（β = 0.3505）以及发病前6个月的重大金融危机（β = 0.4575）。
所确定的预测变量有可能帮助将高危个体分层为可能的AAO组，为治疗提供和早期干预提供依据。
