不同发作类型双相障碍患者自知力及服药态度比较

Comparison study of insight and attitude toward medication of bipolar disorder patients in different episode subtypes

目的比较躁狂发作、抑郁发作及混合状态的双相障碍住院患者出院前的自知力及服药态度,以了解不同发作类型双相障碍的自知力及服药态度在出院前的差异,为出院后制定康复方案提供参考。方法连续入组罗定市第三人民医院2014年5月-2016年12月收治的符合《国际疾病分类(第10版)》(ICD-10)诊断标准的双相障碍住院患者266例,其中躁狂发作116例,抑郁发作94例,混合状态56例。采用汉密尔顿抑郁量表17项版(HAMD-17)、杨氏躁狂评定量表(YMRS)、自知力与治疗态度问卷(ITAQ)及服药态度清单(DAI)在出院当天分别评定精神症状、自知力及服药态度。采用单因素方差分析比较三组HAMD-17、YMRS、ITAQ及DAI评分。结果 HAMD-17、YMRS评分组间比较差异均无统计学意义(P均>0.05)。ITAQ、DAI评分组间比较差异有统计学意义(F=6.205、5.481,P=0.002、0.005),两两比较结果显示,抑郁发作组及混合状态组ITAQ、DAI评分均高于躁狂发作组,差异均有统计学意义(P均<0.05);抑郁发作组及混合状态组ITAQ、DAI评分比较差异无统计学意义(P均>0.05)。结论不同发作类型的双相障碍住院患者出院前的自知力及服药态度存在差异,躁狂发作患者的自知力及服药态度较抑郁发作及混合状态患者差。

Objective To compare the insight and attitude toward medication in different episode subtypes of bipolar disorder,in order to learn the difference of insight and attitude toward medication in different episode subtypes of bipolar disorder when discharged from hospital,and to provides references for rehabilitation program after discharge.Methods 266 inpatients diagnosed with bipolar disorder according to International Classification of Diseases,tenth edition(ICD-10)were recruited,including 116 mania episode,94 depression episode and 56 euthymia episode.Hamilton Depression Scale-17 item(HAMD-17),Young Manic Rating Scale(YMRS),Insight and Treatment Attitude Questionnaire(ITAQ),Drug Attitude Inventory(DAI)were used to assess psychiatric symptoms,insight and attitude toward medication at discharge.One-way analysis of variance(ANOVA)was used to compare HADM-17,YMRS,ITAQ and DAI scores among groups.Results There was no statistically significant difference in HAMD-17,YMRS among three groups(all P>0.05).There was statistically significant difference in ITAQ,DAI scores among three groups(F=6.205,5.481;P=0.002,0.005).ITAQ,DAI scores in depression and euthymia groups were higher than mania group(all P<0.05),but no statistically significant difference was showed between depression group and euthymia group(P>0.05).Conclusion Differences of insight and attitude toward medication are emerged in different episode subtypes of bipolar disorder when discharged from hospital.The insight and attitude toward medication in mania episode patients are worse than depression and euthymia episode patients.