Jung Wooyoung, Moon Eunsoo, Lim Hyun Ju, Park Je Min, Lee Byung Dae, Lee Young Min, Jeong Heejeong, Suh Hwagyu, Kim Kyungwon
Jung Wooyoung Psychiatry Clinic, Busan, Korea.
Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Clin Psychopharmacol Neurosci. 2024 May 31;22(2):263-275. doi: 10.9758/cpn.23.1089. Epub 2023 Jul 27.
Although maintenance treatment for mood disorders is important, the treatment discontinuation rate is reported to be high. This study aimed to investigate the dropout rates and associated factors in mood disorders.
The patients in a mood disorder clinic (n = 535) were examined. Demographic and clinical factors, scores of psychometric scales, time to dropout from initial treatment in patients with bipolar disorder (BP) (n = 288) and depressive disorder (DD) (n = 143) were evaluated based on database of the mood disorder clinic.
Among the studied patients with BP and DD, 50% showed dropout in 4.05 and 2.17 years, respectively. The mean survival times were 8.90 years in bipolar disorder I (BP-I), 5.19 years in bipolar II disorder, 3.22 years in bipolar disorder not otherwise specified, 4.24 years in major depressive disorder, and 4.03 years in other depressive disorders. In the multivariate Cox proportional hazards regression model in the BP group, diagnosis BP-I was found to be significantly related to the decrease in dropout rate (hazard ratio [HR] = 0.22, = 0.001); however, increased past suicide attempt number was significantly related to the increase in dropout rate (HR = 1.13, = 0.017). In the DD group, none of anxiety disorders as comorbidity, increased scores of openness, and extraversion personality were related to the increase in dropout rate.
Patients with BP, especially BP-I, showed a lower dropout rate as compared to patients with other mood disorders.
尽管情绪障碍的维持治疗很重要，但据报道治疗中断率很高。本研究旨在调查情绪障碍的脱落率及相关因素。
对一家情绪障碍诊所的患者（n = 535）进行了检查。基于该情绪障碍诊所的数据库，评估了人口统计学和临床因素、心理测量量表得分、双相情感障碍（BP）患者（n = 288）和抑郁症（DD）患者（n = 143）从初始治疗开始的脱落时间。
在研究的BP和DD患者中，分别有50%在4.05年和2.17年出现脱落。双相I型障碍（BP-I）的平均生存时间为8.90年，双相II型障碍为5.19年，未另行指定的双相情感障碍为3.22年，重度抑郁症为4.24年，其他抑郁症为4.03年。在BP组的多变量Cox比例风险回归模型中，发现诊断为BP-I与脱落率降低显著相关（风险比[HR]=0.22，P = 0.001）；然而，既往自杀未遂次数增加与脱落率增加显著相关（HR = 1.13，P = 0.017）。在DD组中，合并焦虑障碍、开放性得分增加和外向型人格均与脱落率增加无关。
与其他情绪障碍患者相比，BP患者，尤其是BP-I患者的脱落率较低。
