학술논문
不同发病年龄的双相障碍患者的临床表现 / Comparison of clinically relevant factors in bipolar disorder patients with different age of onset
Document Type
Academic Journal
Author
马严; 田霄翌; 黄悦勤; 刘肇瑞; 邓咏妍; 周亮; 刘燕; 刘波; 章杰; 龚元东; 付祥; 赵琼仙; 卢瑾; 沙万年; 合浩; 沈宗霖; 张婷婷; 陈文明; MA Yan; TIAN Xiaoyi; HUANG Yueqin; LIU Zhaorui; DENG Yongyan; ZHOU Liang; LIU Yan; LIU Bo; ZHANG Jie; GONG Yuandong; FU Xiang; ZHAO Qiongxian; LU Jin; SHA Wannian; HE Hao; SHEN Zonglin; ZHANG Tingting; CHEN Wenming
Source
中国心理卫生杂志 / Chinese Mental Health Journal. 38(1):42-49
Subject
Language
Chinese
ISSN
1000-6729
Abstract
目的:比较不同发病年龄的双相障碍患者的临床特征、治疗情况和生理指标.方法:选取符合精神障碍诊断与统计手册第5版(DSM-5)双相障碍诊断标准的患者380例,由精神科医生采用简明国际神经精神访谈进行疾病诊断,用自编临床资料访谈表和功能大体评定量表进行临床特征、治疗情况和生理指标的评估,以21岁和35岁作为双相障碍发病年龄的分界点,进行logistic回归和多重线性回归分析.结果:早发组199例(52.4％),中发组121例(31.8％),晚发组60例(15.8％).首次诊断为抑郁症的比例在早发组为26.6％,中发组为23.1％,晚发组为11.7％.与早发组相比,中发组(OR=2.22)和晚发组(OR=4.99)处于抑郁发作状态的风险更高;晚发组(OR=6.74)罹患双相Ⅱ型障碍风险为6.74倍;中发组(β=-1.52)和晚发组(β=-4.29)的延迟治疗时间更短,中发组(β=-1.62)和晚发组(β=-3.14)的住院次数更少,中发组(β=-28.39)和晚发组(β=-31.47)的尿酸含量更低,中发组(β=-0.23)的总胆固醇的含量更低.结论:不同发病年龄的双相障碍患者在临床特征、治疗情况和生理指标方面存在差异.
Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.
Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.