双相情感障碍患者认知障碍、抑郁症状与工作效率损失之间的关联：一项横断面分析。
Associations Between Cognitive Impairment, Depressive Symptoms, and Work Productivity Loss in Patients With Bipolar Disorder: A Cross-Sectional Analysis.
作者信息
Takaesu Yoshikazu, Shiroma Ayano, Nosaka Tadashi, Maruyama Hidenori
机构信息
Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Medical Affairs, Sumitomo Pharma Co. Ltd., Tokyo, Japan.
出版信息
Neuropsychopharmacol Rep. 2025 Mar;45(1):e70012. doi: 10.1002/npr2.70012.
AIM
To evaluate the relationship between cognitive impairment and work productivity loss in patients with bipolar disorder.
METHODS
We enrolled outpatients with bipolar disorder aged 18-59 years undergoing treatment and actively employed or on sick leave. Baseline demographic, medical resource use, and employment data were collected. We evaluated work productivity, cognitive impairment, quality of life (QOL), depressive symptoms (defined as a Patient Health Questionnaire-9 [PHQ-9] score of ≥ 10), and sleep disturbance. This interim analysis examined correlations among baseline symptom scores and correlations of each symptom score with work productivity loss and QOL.
RESULTS
Among 211 participants, cognitive impairment was moderately correlated with depressive symptoms (r = 0.595) and insomnia (r = 0.481), and depressive symptoms and insomnia were highly correlated (r = 0.719) (all p < 0.001). Work productivity loss (presenteeism) was moderately correlated with cognitive impairment (r = 0.474), depression (r = 0.577), and insomnia (r = 0.547) (all p < 0.001). Depression had the strongest influence on presenteeism (multiple regression analysis, regression coefficient: 22.98; p < 0.001). Among participants without severe depressive symptoms (PHQ-9 ≤ 19), cognitive impairment (13.91, p = 0.007) and insomnia (13.80, p = 0.016) strongly affected presenteeism. Among participants without moderately severe or severe depressive symptoms (PHQ-9 ≤ 14), insomnia affected presenteeism (23.14, p = 0.011). QOL was moderately negatively associated with cognitive impairment (r = -0.653), depression (r = -0.699), and insomnia (r = -0.559) (all p < 0.001). In multiple regression analysis, cognitive impairment (-0.12, p < 0.001), depression (-0.12, p = 0.010), and insomnia (-0.16, p < 0.001) were significantly associated with QOL.
CONCLUSIONS
Treatment should focus on improving the core symptoms of bipolar disorder, insomnia, and cognitive impairment.
TRIAL REGISTRATION
UMIN Clinical Trials Registry (UMIN000051519).
目的
评估双相情感障碍患者认知障碍与工作效率损失之间的关系。
方法
我们纳入了年龄在18 - 59岁、正在接受治疗且在职或正在休病假的双相情感障碍门诊患者。收集了基线人口统计学、医疗资源使用和就业数据。我们评估了工作效率、认知障碍、生活质量（QOL）、抑郁症状（定义为患者健康问卷 - 9 [PHQ - 9] 得分≥10）和睡眠障碍。这项中期分析研究了基线症状评分之间的相关性以及每个症状评分与工作效率损失和生活质量的相关性。
结果
在211名参与者中，认知障碍与抑郁症状（r = 0.595）和失眠（r = 0.481）中度相关，抑郁症状和失眠高度相关（r = 0.719）（所有p < 0.001）。工作效率损失（出勤主义）与认知障碍（r = 0.474）、抑郁（r = 0.577）和失眠（r = 0.547）中度相关（所有p < 0.001）。抑郁对出勤主义的影响最强（多元回归分析，回归系数：22.98；p < 0.001）。在没有严重抑郁症状（PHQ - 9≤19）的参与者中，认知障碍（13.91，p = 0.007）和失眠（13.80，p = 0.016）对出勤主义有强烈影响。在没有中度严重或严重抑郁症状（PHQ - 9≤14）的参与者中，失眠影响出勤主义（23.14，p = 0.011）。生活质量与认知障碍（r = -0.653）、抑郁（r = -0.699）和失眠（r = -0.559）中度负相关（所有p < 0.001）。在多元回归分析中，认知障碍（-0.12，p < 0.001）、抑郁（-0.12，p = 0.010）和失眠（-0.16，p < 0.001）与生活质量显著相关。
结论
治疗应侧重于改善双相情感障碍的核心症状、失眠和认知障碍。
试验注册
UMIN临床试验注册中心（UMIN000051519）。
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