双相情感障碍多次住院649例心境发作模式调查  

Investigation on mood episodes in 649 inpatients with bipolar disorder during multiple admissions.

作　　者：黄雨虹 郭栋梁 蒋贤飞 徐芳芳[2] 苏中华[2] HUANG Yuhong;GUO Dongliang;JIANG Xianfei(Jining Medical University, Jining 272067, China)

机构地区：[1]济宁医学院,山东济宁272067 [2]济宁市精神病防治院

出　　处：《精神医学杂志》2019年第6期433-436,共4页Journal of Psychiatry

摘　　要：目的了解双相情感障碍患者多次住院时抑郁发作、躁狂发作及混合发作等不同心境发作的时相规律,以加深对双相情感障碍临床发作特征的认识。方法选取649例多次住院的双相情感障碍患者为研究对象,根据临床时相分为双相躁狂组(355例)、双相抑郁组(230例)、双相混合组(64例),应用自编双相情感障碍住院患者心境发作模式资料收集表采集患者多次住院的心境发作临床相,计算历次住院时相一致率、时相转换率、延迟诊断率、延迟诊断时间和误诊率等。结果三组住院次数比较差异有统计学意义(P<0.05),双相抑郁组多于双相躁狂组(P<0.05)。三组时相一致率、时相转换率、诊断延迟率、误诊率比较差异有统计学意义(P<0.01)。双相躁狂组时相一致率高于双相抑郁组、双相混合组(P<0.01);双相抑郁组时相转换率高于双相躁狂组、双相混合组(P<0.01),双相混合组时相转换率高于双相躁狂组(P<0.01);双相躁狂组诊断延迟率低于双相抑郁组、双相混合组(P<0.01);双相混合组误诊率高于双相抑郁组、双相躁狂组(P<0.01)。结论研究单位双相障碍患者历次住院的心境发作时相比较复杂,近60%的患者历次住院均以同一临床相入院,其中以双相躁狂者更为常见;近40%的患者出现时相转换、延迟诊断及误诊,其中双相抑郁者更容易出现延迟诊断,双相混合者更容易出现误诊。Objective To explore the regularity of different mood episodes such as depressive episode,manic episode or mixed episode in patients with bipolar disorder(BD)during multiple admissions for further acquaintance of the clinical character of paroxysm of BD.Methods A total of 649 inpatients with BD were selected and divided into bipolar-mania group(355 cases),bipolar-depression group(230 cases)and bipolar-mixed group(64 cases)according to their different clinical phases.To collect the data of mood phases at multiple admissions with customized collection table which was used for analyzing the regularity of different phases during the progress and calculating the phase consistency rate,phase conversion rate,delayed diagnosis rate,delay-time of diagnosis and misdiagnosis rate at every single time of admissions.Results There existed significant difference in admission times among three groups(P<0.05),and bipolar-depression group showed more admission times than bipolar-mania group(P<0.05).There existed significant differences in phase consistency rates,phase conversion rates,delayed diagnosis rates and misdiagnosis rates among three groups(P<0.01).Bipolar-mania group showed higher phase consistency rate than bipolar-depression group and bipolar-mixed group(P<0.01).Bipolar-depression group showed higher phase conversion rate than bipolar-mania group and bipolar-mixed group(P<0.01);bipolar-mixed group showed higher phase conversion rate than bipolar-mania group(P<0.01).Bipolar-mania group showed lower delayed diagnosis rate than bipolar-depression group and bipolar-mixed group(P<0.01).Bipolar-mixed group showed higher misdiagnosis rate than bipolar-depression group and bipolar-mania group(P<0.01).Conclusion The mood episodes of inpatients with BD are complicated during each admission.Approximately 60%of the inpatients are admitted in the same clinical phase,in which bipolar mania is more common;and 40%of the inpatients show phase conversion,delayed diagnosis and misdiagnosis,in which delayed diagnosis is more likely to occ

关 键 词：双相情感障碍 时相一致率 时相转换率 延迟诊断率 延迟诊断时间 误诊率 

分 类 号：R749.4[医药卫生—神经病学与精神病学]