Mood and Anxiety Disorders Program (CETHA), Federal University of Bahia (UFBA), Salvador, BA, Brazil.
Postgraduate Program in Medicine and Health, UFBA, Salvador, BA, Brazil.
Eur Arch Psychiatry Clin Neurosci. 2023 Aug;273(5):1175-1181. doi: 10.1007/s00406-023-01562-5. Epub 2023 Feb 1.
The aim was to assess the lifetime prevalence of psychiatric comorbidity (PC) in Brazilian euthymic individuals with bipolar disorder type I, and investigate its effects on clinical outcomes and functioning. A group of 179 outpatients with BD-I in the recuperation phase were assessed, of whom 75 (41.9%) had PC and 104 (58.1%) had not. Both groups were compared using sociodemographic/clinical questionnaire, Structured Clinical Interview for DSM-IV axis I and II, Sheehan Disability and Barratt Impulsiveness Scales. Patients with PC presented less religious affiliation, more history of lifetime psychotic symptoms, rapid cycling, suicide attempts, worse scores of functioning, and higher prevalence of personality disorders. Ordinal logistic regression indicated that PC was associated with increased odds of worse levels of disability. Therefore, it could be observed that patients with BD evaluated only in euthymia presented a high mental disorders comorbidity. Considering their burdensome impact, appropriate management is a challenging reality and a crucial factor in reducing morbidity and mortality associated with BD. Further longitudinal studies on their relationship may broaden interventions to reduce patient's suffering.
目的在于评估巴西单相双相情感障碍 I 型缓解期患者的终生精神共病（PC）患病率，并调查其对临床结局和功能的影响。对 179 名单相双相情感障碍 I 型缓解期门诊患者进行评估，其中 75 名（41.9%）存在 PC，104 名（58.1%）无 PC。使用社会人口统计学/临床问卷、DSM-IV 轴 I 和 II 结构临床访谈、Sheehan 残疾量表和 Barratt 冲动量表对两组患者进行比较。存在 PC 的患者宗教信仰程度较低，更可能有终生精神病症状史、快速循环、自杀企图，功能评分较差，且更易患人格障碍。有序逻辑回归表明，PC 与更差的残疾水平的几率增加相关。因此，可以观察到仅在缓解期评估的双相情感障碍患者存在较高的精神障碍共病。考虑到其带来的负担，适当的管理是一个具有挑战性的现实，也是降低与双相情感障碍相关的发病率和死亡率的关键因素。进一步研究其相关性可能会为减少患者痛苦提供干预措施。
