双相情感障碍中躁狂和抑郁发作频率的相关因素：一项中国的多中心研究。

Factors associated with the frequency of manic and depressive episodes in bipolar disorder: a multicenter study in China.

作者信息

Liu Shuang, Xu Jin-Jie, Zhu Xue-Quan, Fu Bing-Bing, Pan Yan-Li, Sun Cong-Cong, Li Sheng, Xie Gao-Ming, Zhang Ling

机构信息

Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.

Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.

出版信息

BMC Psychiatry. 2025 May 20;25(1):507. doi: 10.1186/s12888-025-06863-8.

DOI:10.1186/s12888-025-06863-8

PMID:40394517

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12093766/

Abstract

BACKGROUND

Mania and depression are the predominant mood episodes in bipolar disorder (BD), and their frequency significantly affects the long-term prognosis of patients.

METHOD

This is a multicenter, longitudinal cohort study in China. Sociodemographic and clinical characteristics of patients were statistically analyzed. Poisson regression analyses were performed to identify factors associated with the frequency of manic and depressive episodes.

RESULTS

A total of 520 BD patients were enrolled in this study. Poisson regression model analysis showed that shorter years of education (OR = 1.03, P = 0.03), mixed polarity of the first episode compared to mania (OR = 2.33, P < 0.01) or depression (OR = 1.79, P = 0.01), earlier age at diagnosis (OR = 1.03, P = 0.01), comorbid substance use disorder (OR = 1.41, P = 0.02), presence of psychotic symptoms (OR = 1.18, P = 0.04), use of antidepressant medication (OR = 1.52, P = 0.01), and non-use of mood stabilizers (OR = 1.57, P<0.01) are positively associated with the frequency of manic episodes. Being male (OR = 1.22, P = 0.01), the use of mood stabilizers (OR = 1.47, P<0.01) and a diagnosis of bipolar II disorder (BD-II) compared to bipolar I disorder (BD-I) (OR = 1.27, P = 0.01) are positively associated with the frequency of depressive episodes.

CONCLUSION

The study highlights the critical association of clinical and sociodemographic factors with the frequency of manic and depressive episodes in BD patients. Addressing these factors may improve long-term outcomes for individuals with bipolar disorder.

摘要

背景

躁狂和抑郁是双相情感障碍（BD）的主要情绪发作类型，它们的发作频率显著影响患者的长期预后。

方法

这是一项在中国开展的多中心纵向队列研究。对患者的社会人口学和临床特征进行了统计分析。进行泊松回归分析以确定与躁狂和抑郁发作频率相关的因素。

结果

本研究共纳入520例双相情感障碍患者。泊松回归模型分析显示，受教育年限较短（OR = 1.03，P = 0.03）、首发为混合极性而非躁狂（OR = 2.33，P < 0.01）或抑郁（OR = 1.79，P = 0.01）、诊断年龄较早（OR = 1.03，P = 0.01）、合并物质使用障碍（OR = 1.41，P = 0.02）、存在精神病性症状（OR = 1.18，P = 0.04）、使用抗抑郁药物（OR = 1.52，P = 0.01）以及未使用心境稳定剂（OR = 1.57，P < 0.01）与躁狂发作频率呈正相关。男性（OR = 1.22，P = 0.01）、使用心境稳定剂（OR = 1.47，P < 0.01）以及与双相I型障碍（BD-I）相比诊断为双相II型障碍（BD-II）（OR = 1.27，P = 0.01）与抑郁发作频率呈正相关。