Tennant Matthew, Porter Richard, Beaglehole Ben
Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
Bipolar Disord. 2024 Dec;26(8):764-771. doi: 10.1111/bdi.13491. Epub 2024 Aug 26.
Register-based cohorts allow us to better understand bipolar disorder over a life course. They are inclusive and their long-term data collection provides a longer scope than most clinical trials. This mapping review provides an overview of register-based cohort studies of bipolar disorder to inform researchers of the strengths and limitations to this body of research and identify gaps for future research.
A systematic search was performed of Medline, EMBASE, and PsycINFO databases. Cohort studies were included if they focused on bipolar disorder and had a minimum of 1 year of longitudinal data. Studies needed to be from databases that monitor the whole state or national population. A descriptive analysis of the studies' populations and methodology provides an overview of this field of study and identifies evidence gaps.
A hundred and forty-six studies were included. The majority were from databases in Taiwan (n = 63), Denmark (n = 38), Sweden (n = 23), and Finland (n = 11). Forty-eight studies focused on aetiological questions. Sixty prognostic studies identified cohorts with bipolar disorder and described the impact of the illness by considering comorbidity, prescribing patterns, social functioning, and mortality. Thirty-six treatment studies focused on the efficacy and adverse effects of pharmaceuticals and ECT. No studies focused on psychological treatments.
Bipolar disorder research should include register-based cohorts with greater geopolitical and cultural diversity. Custodians of health registers should consider how non-pharmaceutical interventions such as psychotherapy are captured. Register-based cohorts investigating treatments of bipolar disorder should consider long-term social outcomes alongside the usual clinical outcomes.
基于登记册的队列研究使我们能够更好地了解双相情感障碍在整个生命历程中的情况。这些研究具有包容性，其长期数据收集提供了比大多数临床试验更长的时间范围。本映射综述概述了基于登记册的双相情感障碍队列研究，以告知研究人员该研究主体的优势和局限性，并确定未来研究的差距。
对Medline、EMBASE和PsycINFO数据库进行了系统检索。如果队列研究聚焦于双相情感障碍且至少有1年的纵向数据，则纳入研究。研究需来自监测整个州或全国人口的数据库。对研究人群和方法进行描述性分析，以概述该研究领域并确定证据差距。
纳入了146项研究。大多数研究来自台湾（n = 63）、丹麦（n = 38）、瑞典（n = 23）和芬兰（n = 11）的数据库。48项研究聚焦于病因学问题。60项预后研究确定了双相情感障碍队列，并通过考虑合并症、处方模式、社会功能和死亡率来描述疾病的影响。36项治疗研究聚焦于药物和ECT的疗效及不良反应。没有研究聚焦于心理治疗。
双相情感障碍研究应纳入具有更大地缘政治和文化多样性的基于登记册的队列。健康登记册的管理者应考虑如何记录心理治疗等非药物干预措施。基于登记册的双相情感障碍治疗队列研究应在常规临床结果之外考虑长期社会结果。
