Fengli Sun, Jianfeng Zhu, Hejian Tao, Weidong Jin
Department of Psychiatry, Zhejiang Province Mental Health Center, Zhejiang Province Tongde Hospital, Hangzhou, China.
Department of Psychiatry, Second Hospital of Yuhang, Yuhang, China.
Psychiatry Clin Psychopharmacol. 2021 Jun 1;31(2):173-180. doi: 10.5152/pcp.2021.21425. eCollection 2021 Jun.
Bipolarity index (BI) is one of the diagnostic scales that assist the diagnosis of bipolar disorder (BD), and should be analyzed comprehensively for use in China.
We searched the Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG, and Chinese Social Sciences Citation Index (CSSCI) in Chinese to find literature from July 31, 2004 to July 31, 2020, for results related to BI in the diagnosis for bipolar disorder (BD), among which results such as comments, letters, reviews, and case reports were excluded. The rates of sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in diagnosis were synthesized and discussed.A total of 1237 patients were included in 5 studies. The criteria used for their selection were an anlysis of their results on the BI, and the diagnostic indexes of BI for BD in China.Thesensitivity, specificity, positive predictive value, negative predictive value, and accuracy of BI for BD in China were summarized in every study. A total of 1237 subjects were included in 5 studies. The random effect model was used to account for the data with RevMan 5.2. The results showed that the diagnostic sensitivity of BI was 0.93 (95% CI: 0.93-1.00), and the specificity was 85% (95% CI: 0.69-0.96). The positive predictive value (PPV)was 74% (95% CI: 0.53-0.91). The negative predictive value (NPV) was 95% (95% CI: 0.81-1.00), and accuracy was 86% (95% CI: 0.77-0.93). Significant heterogeneity was detected across studies regarding these incidence estimates. The ideal diagnostic value of BI was found, although the studies showed significant heterogeneity. The results must be cautiously and attentively interpreted, in comparison to other diagnostic scales, to perfect the use of BI in clinical psychiatry.
双相性指数（BI）是辅助双相情感障碍（BD）诊断的诊断量表之一，在中国应用时应进行综合分析。
检索中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库和中文社会科学引文索引（CSSCI），查找2004年7月31日至2020年7月31日期间与双相情感障碍（BD）诊断中BI相关的文献，排除评论、信函、综述和病例报告等类型的结果。综合并讨论诊断中的敏感性、特异性、准确性、阳性预测值和阴性预测值。5项研究共纳入1237例患者。纳入标准为对其BI结果进行分析以及中国BD的BI诊断指标。总结每项研究中中国BD的BI敏感性、特异性、阳性预测值、阴性预测值和准确性。5项研究共纳入1237名受试者。使用RevMan 5.2软件的随机效应模型处理数据。结果显示，BI的诊断敏感性为0.93（95%CI：0.93 - 1.00），特异性为85%（95%CI：0.69 - 0.96）。阳性预测值（PPV）为74%（95%CI：0.53 - 0.91）。阴性预测值（NPV）为95%（95%CI：0.81 - 1.00），准确性为86%（95%CI：0.77 - 0.93）。各研究间这些发病率估计值存在显著异质性。尽管研究显示存在显著异质性，但仍发现了BI的理想诊断价值。与其他诊断量表相比，对结果的解读必须谨慎且细致，以完善BI在临床精神病学中的应用。
