NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Psychol Med. 2022 Oct;52(13):2413-2425. doi: 10.1017/S003329172200201X. Epub 2022 Aug 26.
Psychotic symptoms, that we defined as delusions or hallucinations, are common in bipolar disorders (BD). This systematic review and meta-analysis aims to synthesise the literature on both lifetime and point prevalence rates of psychotic symptoms across different BD subtypes, including both BD type I (BDI) and BD type II (BDII). We performed a systematic search of Medline, PsycINFO, Embase and Cochrane Library until 5 August 2021. Fifty-four studies ( = 23 461) of adults with BD met the predefined inclusion criteria for evaluating lifetime prevalence, and 24 studies ( = 6480) for evaluating point prevalence. Quality assessment and assessment of publication bias were performed. Prevalence rates were calculated using random effects meta-analysis, here expressed as percentages with a 95% confidence interval (CI). In studies of at least moderate quality, the pooled lifetime prevalence of psychotic symptoms in BDI was 63% (95% CI 57.5-68) and 22% (95% CI 14-33) in BDII. For BDI inpatients, the pooled lifetime prevalence was 71% (95% CI 61-79). There were no studies of community samples or inpatient BDII. The pooled point prevalence of psychotic symptoms in BDI was 54% (95 CI 41-67). The point prevalence was 57% (95% CI 47-66) in manic episodes and 13% (95% CI 7-23.5) in depressive episodes. There were not enough studies in BDII, BDI depression, mixed episodes and outpatient BDI. The pooled prevalence of psychotic symptoms in BDI may be higher than previously reported. More studies are needed for depressive and mixed episodes and community samples.Prospero registration number: CRD 42017052706.
精神病症状，我们定义为妄想或幻觉，在双相情感障碍 (BD) 中很常见。本系统评价和荟萃分析旨在综合不同 BD 亚型（包括双相情感障碍 I 型 (BDI) 和双相情感障碍 II 型 (BDII)）的精神病症状终身和时点患病率的文献。我们对 Medline、PsycINFO、Embase 和 Cochrane Library 进行了系统检索，截至 2021 年 8 月 5 日。符合评估终生患病率的预定义纳入标准的 54 项成人 BD 研究（=23461）和评估时点患病率的 24 项研究（=6480）符合纳入标准。进行了质量评估和发表偏倚评估。使用随机效应荟萃分析计算患病率，此处表示为百分比和 95%置信区间（CI）。在至少为中等质量的研究中，BDI 中精神病症状的终生患病率为 63%（95%CI 57.5-68），BDII 中为 22%（95%CI 14-33）。BDI 住院患者的终生患病率为 71%（95%CI 61-79）。没有关于社区样本或住院 BDII 的研究。BDI 中精神病症状的时点患病率为 54%（95%CI 41-67）。躁狂发作时点患病率为 57%（95%CI 47-66），抑郁发作时点患病率为 13%（95%CI 7-23.5）。BDII、BDI 抑郁、混合发作和门诊 BDI 研究不足。BDI 中精神病症状的总患病率可能高于之前的报告。需要更多研究抑郁和混合发作以及社区样本。Prosporo 注册号：CRD 42017052706。
