双相情感障碍共病酒精使用障碍患者的临床特征及影响因素

Study on Clinical Characteristics and Influencing Factors of Bipolar Disorder Comorbid with Alcohol Use Disorder

【目的】分析双相情感障碍患者共病酒精使用障碍患者的临床特征及其影响因素。【方法】以河北省精神卫生中心住院的双相情感障碍患者为研究对象,根据是否共病酒精使用障碍将其分为共病组(n=51)和非共病组(n=97)。以美国精神障碍诊断与统计手册-第5版修订版(DSM-5)为诊断标准,对研究对象进行再次诊断。同时采用一般情况调查表、应对方式问卷对研究对象进行调查并进行相关因素分析。【结果】共病组与非共病组在性别、受教育程度、家庭关系、职业、病前性格、嗜酒家族史、起病形式等方面存在差异(P<0.05)。在各种风险评估方面,共病组冲动行为及自伤行为均高于非共病组,差异有统计学意义(P<0.05)。共病组应对方式采用解决问题的评分低于非共病组,而采用自责的应对方式评分高于较非共病组高,差异均有统计学意义(P<0.05)。非条件多因素Logistic回归分析,结果显示男性、有冲动行为、急性及亚急性起病是共病酒精使用障碍的危险性因素(P<0.05);而小学及以下、高中/中专受教育程度、工人、农民、病前性格内向是共病酒精使用障碍的保护性因素(P<0.05)。【结论】住院双相情感障碍患者共病酒精使用障碍的比例不低,共病患者较少采用解决问题的应对方式,发生冲动行为风险较高。

【Objective】To investigate the clinical characteristics and influencing factors of bipolar disorder comorbid with alcohol use d isord er.【Methods】Patients with bipolar disorder who were hospitalized at the Hebei Mental Health Center were divided into comorbid groups(n=51)and non-comorbid groups(n=97)according to the status of comorbid alcohol use disorders.The diagnostic criteria were based on the Diagnostic and Statistical Manual of Mental Disorders in the United States(the fifth revised edition,DSM-5).At the same time,general situation questionnaire and response questionnaire were used to survey the subjects and analyze the relevant factors.【Results】There were differences between the comorbid group and the non-comorbid group in terms of gender,education level,family relationship,occupation,pre-disease personality,family history of alcoholism,and the onset of disease(P<0.05).In various risk assessments,impulsive behavior and self-injury behavior of the comorbid group were higher than those of the non-comorbid group,and the difference was statistically significant(P<0.05).The score of problem-solving approach style in the comorbid group was lower than that in the non-comorbid group(P<C0.05),while the self-blame coping style of the comorbid group was higher than that of the non-com orbid group(P<0.05).Unconditional multivariate Logistic regression analysis showed that male,impulsive behavior,acute and subacute onset were risk factors for comorbid alcohol use disorder(P<0.05),while elementary education and below,high school/secondary education,workers,farm ers,and introverted personality before illness were protective factors for comorbid alcohol use disorder(P<0.05).【Conclusion】The proportion of comorbid alcohol use disorder in hospitalized patients with bipolar disorder is not low at all.The comorbid patients are less likely to adopt problem-solving approaches,instead they have a higher risk of impulsive behavior.