Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States of America.
Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, United States of America; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America.
J Affect Disord. 2024 Dec 1;366:317-325. doi: 10.1016/j.jad.2024.08.133. Epub 2024 Aug 25.
Knowledge of clinical, treatment and life circumstances of individuals with bipolar I disorder (BP-I) in US households is informed by decades old epidemiological surveys.
The Mental and Substance Use Disorders Prevalence Study was conducted October 2020-October 2022. Clinicians administered the Structured Clinical Interview for the DSM-5 diagnosing 12-month prevalence of BP-I and other mental health disorders (MHD) among 4764 adults aged 18-65 years and collected sociodemographic information. We examined clinical characteristics, differences by sex and age among adults with BP-I, and compared adults with BP-I versus no MHD regarding sociodemographic characteristics, functioning, and substance use disorders (SUDs).
Prevalence of BP-I in the MDPS was 1.5 %. Among those with BP-I, 73.4 % had comorbid psychiatric disorders, and 43.4 % had comorbid SUDs. Alcohol use disorder was higher in those with BP-I versus no MHD (33.0 % vs. 6.3 %). Mean Global Assessment of Functioning scores were lower among those with BP-I versus no MHD (53.2 vs. 77.0). Of individuals with BP-I, 64.9 % had past-year outpatient, 5.4 % inpatient, and 18.7 % minimally adequate treatment (≥1 antimanic agent and ≥ 4 outpatient visits). Individuals with BP-I were less likely to be employed (37.3 % vs. 63.0 %) and have a family income ≥$20,000 (48.2 % vs. 81.9 %) versus no MDPS MHD.
The survey response rate was low.
In this sample, many individuals with BP-I had psychiatric and SUD comorbidities, lived in poverty and had functional impairment. Few received adequate treatment; women and younger individuals were particularly disadvantaged. Early detection and treatment represent substantial opportunities to improve outcomes.
美国居民对双相情感障碍（BP-I）患者的临床、治疗和生活情况的了解来自于几十年前的流行病学调查。
精神和物质使用障碍患病率研究于 2020 年 10 月至 2022 年 10 月进行。临床医生使用 DSM-5 结构化临床访谈诊断了 4764 名 18-65 岁成年人中 12 个月的 BP-I 和其他心理健康障碍（MHD）的患病率，并收集了社会人口统计学信息。我们研究了 BP-I 成年人的临床特征、性别和年龄差异，并比较了 BP-I 成年人与无 MHD 成年人的社会人口统计学特征、功能和物质使用障碍（SUD）。
MDPS 中 BP-I 的患病率为 1.5%。在那些患有 BP-I 的人中，73.4%的人有合并的精神疾病，43.4%的人有合并的 SUD。与无 MHD 的人相比，BP-I 患者的酒精使用障碍发生率更高（33.0% vs. 6.3%）。与无 MHD 的人相比，BP-I 患者的全球功能评估得分更低（53.2 分 vs. 77.0 分）。在那些患有 BP-I 的人中，64.9%的人在过去一年中有门诊治疗，5.4%的人有住院治疗，18.7%的人有最低限度的充分治疗（≥1 种抗躁狂药物和≥4 次门诊就诊）。与无 MDPS MHD 的人相比，BP-I 患者更不可能就业（37.3% vs. 63.0%），并且家庭收入≥$20,000（48.2% vs. 81.9%）的人也较少。
调查的应答率很低。
在这个样本中，许多患有 BP-I 的人有精神和 SUD 合并症，生活贫困，功能受损。很少有人接受充分的治疗；女性和年轻人尤其处于不利地位。早期发现和治疗代表了改善预后的重要机会。
