School of Medicine, IMPACT the Institute for Mental and Physical Health and Clinical Translation, Deakin University, Barwon Health, PO Box 281, Geelong, 3220, Australia.
Barwon Health University Hospital, Geelong, Australia.
BMC Psychiatry. 2022 Sep 20;22(1):620. doi: 10.1186/s12888-022-04258-7.
Falls are a common occurrence in psychiatric hospital settings, however population-based research among individuals with psychiatric disorders, in particular bipolar disorder (BD) is scant. Thus, we aimed to investigate falls risk in community-dwelling women diagnosed with BD.
Women with BD (cases, n = 119) were recruited from health care settings located in southeast Victoria, Australia. Age-matched controls (n = 357, ratio 3:1) without BD were participants in the Geelong Osteoporosis Study drawn from the same geographical region. Lifetime history of BD was identified by semi-structured clinical interview (SCID-IV/NP). Previous 12-month falls data were obtained via questionnaire. Information on mobility, alcohol use, general health, medication use, blood pressure, body mass index, socioeconomic status and use of a walking aid was collected. Generalised Estimating Equations, binary and ordinal logistic regression were used to determine the odds ratio (OR) and 95% confidence interval (CI) for falls following adjustment for confounders.
During the 12-month period, 34 (28.6%, median age 48.4 yr) cases and 70 (19.6%, median age 49.1 yr) controls reported one fall; 22 (18.5%) cases and 18 (5.0%) controls reported ≥ two falls (p < 0.001). Cases had 2.5-fold increased odds of at least one fall and 2.9-fold increased likelihood of increasing falls categories (0 vs. 1 vs. 2 +), compared to controls [adjOR 2.5, 95%CI (1.8, 3.4), adjOR OR 2.9, 95%CI (2.0, 4.1)].
Risk of falls was greater among women with BD. Balance training could be a research and clinical focus for falls prevention programs among women with bipolar disorder to prevent the detrimental outcomes associated with falling.
在精神病医院环境中，跌倒很常见，但是针对特定为患有精神障碍（尤其是双相情感障碍）的个体的基于人群的研究很少。因此，我们旨在调查在社区居住的被诊断患有双相情感障碍的女性的跌倒风险。
从澳大利亚东南部维多利亚州的医疗保健机构招募了患有双相情感障碍的女性（病例，n=119）。年龄匹配的对照组（n=357，比例为 3：1）没有双相情感障碍，是来自同一地理区域的 Geelong Osteoporosis Study 的参与者。通过半结构式临床访谈（SCID-IV/NP）识别终生的双相情感障碍病史。通过问卷调查获得过去 12 个月的跌倒数据。收集了移动能力、饮酒情况、一般健康状况、用药情况、血压、体重指数、社会经济地位和使用助行器的信息。使用广义估计方程、二元和有序逻辑回归确定调整混杂因素后的跌倒比值比（OR）和 95%置信区间（CI）。
在 12 个月期间，34 名（28.6%，中位年龄 48.4 岁）病例和 70 名（19.6%，中位年龄 49.1 岁）对照报告发生了一次跌倒；22 名（18.5%）病例和 18 名（5.0%）对照报告发生了≥两次跌倒（p<0.001）。与对照组相比，病例发生至少一次跌倒的可能性增加了 2.5 倍，发生跌倒次数增加的可能性增加了 2.9 倍（0 次对 1 次对 2+次）[调整后的 OR 2.5，95%CI（1.8，3.4），调整后的 OR 2.9，95%CI（2.0，4.1）]。
双相情感障碍女性的跌倒风险更高。平衡训练可能是预防双相情感障碍女性跌倒相关不良后果的研究和临床重点。
