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从严重抑郁症转变为双相情感障碍的诊断转换的预测因素:瑞典国家纵向研究
Sang Jin Rhee1, Henrik Ohlsson2, Jan Sundquist2,3
1Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Psychological medicine
|July 10, 2023
概括
预测主要抑郁症 (MD) 转化为双相情感障碍 (BD) 是至关重要的. 关键的风险因素包括家族病史,住院治疗和精神病性抑郁症.
科学领域:
- 精神病学是一个精神病学.
- 临床流行病学临床流行病学
- 遗传学 是一个遗传学.
背景情况:
- 准确预测主要抑郁症 (MD) 转化为双相情感障碍 (BD) 是临床上具有意义的.
- 识别风险因素对于早期干预和改善患者结果至关重要.
研究的目的:
- 为了确定主要抑郁症 (MD) 到双相情感障碍 (BD) 的转化率.
- 确定与此转换相关的关键风险因素.
主要方法:
- 一项瑞典基于人口的队列研究包括1941年以后出生的个人,在2006年至2018年期间首次诊断出MD.
- 来自国家注册的数据被用来评估家庭遗传风险得分 (FGRS),人口统计和临床特征.
- 考克斯的比例危险模型分析了转换率和风险因素,并对晚期转换者和性别分层进行了额外的分析.
主要成果:
- 在13年的时间里,从MD转换为BD的累积发病率为5.84%.
- 确定最强的预测因素是高FGRS的BD (HR=2.73),住院治疗 (HR=2.64),和精神病性抑郁症 (HR=2.58).
- 早期的MD发作 (青少年时期) 和女性性别分别与增加的风险和预测能力有关.
结论:
- 患有BD的家族史,住院治疗和精神病性抑郁症是从MD转化为BD的重要预测因素.
- 这些发现有助于识别针对性干预的高风险个体.
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