以抑郁相为首发的双相情感障碍早期诊断模型研究  

Study on Early Diagnosis Model of Bipolar Disorder with Depressive Phase as the First Episode

作　　者：聂纪伟 谭灵妍 NIE Jiwei;TAN Lingyan(Weifang Mental Health Center,Weifang 261000,China;不详)

机构地区：[1]潍坊市精神卫生中心,山东潍坊261000

出　　处：《中外医学研究》2022年第18期65-69,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：潍坊市卫生健康委项目(WFWSJK-2020-045)。

摘　　要：目的:通过数据分析,建立以抑郁相为首发的双相情感障碍早期诊断模型,并对其进行评价。方法:回顾性分析2012年1月1日-2013年12月31日潍坊市精神卫生中心住院的首发抑郁症患者的临床资料,并进行随访,随访结束后纳入未转躁受试者(单相抑郁症患者)200例为对照组,转躁的受试者(双相情感障碍患者)200例为试验组。对两组资料分析比较,并应用Logistic回归分析建立早期诊断模型。结果:单因素分析结果显示两组起病年龄、发作次数、病前性格特征、初次起病是否伴有精神病性症状、初次起病是否有自杀观念、是否伴有双相情感障碍家族史及三碘甲状腺原氨酸水平比较差异有统计学意义(P<0.05)。多因素分析结果显示起病年龄、发作次数、三碘甲状腺原氨酸水平是单相抑郁是否转躁的独立预测因子。建立联合预测因子(即以抑郁为首发的双相情感障碍早期诊断模型):L=-起病年龄+2.754×发作次数+3.448×三碘甲状腺原氨酸。联合预测因子的敏感度为94.0%,特异度为99.0%,曲线下面积为0.995,95%的置信区间为(0.991,0.999)。结论:以抑郁相为首发的双相情感障碍早期诊断模型可用于临床,对早期疾病鉴别有重要意义。Objective:To develop a model for early diagnosis of bipolar disorder with depressive phase as the first episode by data analysis and to evaluate it.Method:Clinical data of first-episode depression patients hospitalized in Weifang Mental Health Center from January 1,2012 to December 31,2013 were retrospectively analyzed,and follow up the subjects.At the end of follow-up,200 subjects without mania(unipolar depression patients)were included as the control group,and 200 subjects with mania(bipolar disorder patients)were included as the experimental group.The data of the two groups were analyzed and compared,and the early diagnosis model was established by Logistic regression analysis.Result:Univariate analysis showed that there were statistically significant differences between the two groups in age of onset,frequency of onset,personality characteristics before onset,whether the first onset was accompanied by psychotic symptoms,whether the first onset was accompanied by suicidal thoughts,whether accompanied by family history of bipolar disorder,and triiodothyronine level(P<0.05).The results of the multifactorial analysis showed independent predictors of whether unipolar depression turned to mania were age at onset,number of episodes,and triiodothyronine level.Combined predictor(early diagnosis model of bipolar disorder with depressive phase as the first episode)was established:L=-onset age+2.754×number of episodes+3.448×triiodothyronine.The combined predictor had a sensitivity of 94.0%and a specificity of 99.0%.The area under the curve for the combined predictor was 0.995,with a 95%confidence interval of(0.991,0.999).Conclusion:The early diagnosis model of bipolar disorder with depressive phase as the first episode can be used in clinic and is of great significance for early disease identification.

关 键 词：双相情感障碍 单相抑郁 诊断 联合预测因子 

分 类 号：R749.4[医药卫生—神经病学与精神病学]