双相Ⅰ型障碍和双相Ⅱ型患者人口学和临床特征的比较

Comparison of demographic and clinical characteristics of bipolar I disorder and bipolar Ⅱ disorder

目的:比较双相Ⅰ型障碍和双相Ⅱ型障碍患者的人口学特征、临床特征、治疗特征和生理指标。方法:选取符合美国精神障碍诊断与统计手册第5版(DSM-5)双相障碍的患者381例,其中Ⅰ型302例(79.27%),Ⅱ型74例(19.42%),其他特定及相关障碍5例(1.31%)。用自编临床资料访谈表收集人口学资料及临床特征数据。采用多因素logistic回归和多重线性回归分析方法进行因素分析。结果:与双相II型障碍相比,双相I型障碍患者更容易伴有精神病性特征(OR=5.75,95%CI:2.82~11.76),病程更长,接受重复经颅磁刺激治疗较多(OR=3.09,95%CI:1.02~9.35),尿酸、总胆固醇、高密度脂蛋白浓度更高,汉族更常见(OR=11.50,95%CI:1.76~75.30)、受教育程度更低(OR=10.22,95%CI:1.16~89.77),更少有精神病家族史(OR=2.34,95%CI:1.01~5.42)。结论:双相Ⅰ型障碍和双相Ⅱ型障碍的人口学特征、临床特征、治疗情况和生理指标有差异,可为探讨双相障碍的发病机制提供线索。

Objective:To compare demographic characteristics,clinical characteristics,therapeutic characteris-tics and physiological indicators of patients with bipolar I disorder and bipolar II disorder.Methods:A total of 381 patients with bipolar disorder(BD)diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 5th Edi-tion(DSM-5)were selected,including 302 patients with BD-I(79.27%),74 patients with BD-II(19.42%)and 5 patients with other specific and related disorders(1.31%).Demographic and clinical characteristics were collected with self-designed clinical information questionnaire.Multivariate logistic regression and multivariate linear regres-sion analysis were used for analysis.Results:Compared with patients with BD-II,patients with BD-I had more risk to have psychotic features(OR=5.75,95%CI:2.82-11.76),longer disease duration,and more repeated transcra-nial magnetic therapy(OR=3.09,95%CI:1.02-9.35),higher uric acid,total cholesterol and high-density lipo-protein.BD-I in Han nationality was more common(OR=11.50,95%CI:1.76-75.30),and had lower education level(OR=10.22,95%CI:1.16-89.77),and less family history of psychosis(OR=2.34,95%CI:1.01-5.42).Conclusion:There are significant differences between BD-I and BD-II in demographic and clinical charac-teristics,treatment status,and physiological indicators,which could provide clues for exploring the pathogenesis of bipolar disorder.