Feinman J A, Dunner D L
University of Washington Medical Center, Outpatient Psychiatry, Seattle 98105, USA.
J Affect Disord. 1996 Feb 12;37(1):43-9. doi: 10.1016/0165-0327(95)00080-1.
It has been found that > 60% of bipolar I and almost 50% of bipolar II patients have a history of substance abuse (Regier et al., 1990). While previous studies have examined comorbidity of bipolar disorder and substance abuse, little has been done to examine the effect of substance abuse on the course of bipolar disorder. There has also been little distinction made between bipolar disorder occurring prior to substance abuse and that occurring after the onset of substance abuse. Given the high prevalence of substance abuse in bipolar patients, it would be useful to determine more about the effect of substance abuse on demographic and clinical features and on the course of illness. We attempted to do this with a retrospective chart review of 188 bipolar patients seen by D.L. Dunner between January 1992 and December 1993. Demographic and clinical information as well as information about course of illness were systematically extracted from the charts. We compared the means and percentages of these variables and analysed them for significance. Preliminary results show differences in demographics, clinical features and course of illness between patient groups. These differences may illustrate the clinical effects of substance abuse on the course of bipolar disorder. Our results also indicate that there are differences between patients whose bipolar disorder began prior to and those whose disorder began after the onset of substance abuse.
研究发现，超过60%的双相I型患者和近50%的双相II型患者有药物滥用史（雷吉尔等人，1990年）。虽然此前的研究已探讨双相情感障碍与药物滥用的共病情况，但在研究药物滥用对双相情感障碍病程的影响方面做得很少。在药物滥用之前发生的双相情感障碍和在药物滥用开始后发生的双相情感障碍之间也几乎没有区分。鉴于双相情感障碍患者中药物滥用的高发生率，进一步确定药物滥用对人口统计学和临床特征以及病程的影响将很有帮助。我们通过对1992年1月至1993年12月期间D.L.邓纳诊治的188例双相情感障碍患者的病历进行回顾性分析来尝试做到这一点。从病历中系统提取了人口统计学和临床信息以及有关病程的信息。我们比较了这些变量的均值和百分比，并对其进行显著性分析。初步结果显示患者组之间在人口统计学、临床特征和病程方面存在差异。这些差异可能说明了药物滥用对双相情感障碍病程的临床影响。我们的结果还表明，双相情感障碍在药物滥用之前开始的患者与在药物滥用开始后开始患病的患者之间存在差异。
