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快速循环双极性障碍的患病率和结果:混合方法系统的元综述
Alessandro Miola1, Konstantinos N Fountoulakis2, Ross J Baldessarini3
1Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA; International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA.
Journal of psychiatric research
|July 10, 2023
概括
快速循环双极性障碍 (RC-BD) 影响超过四分之一的患者,女性患病率更高. 这种情况与增加的自杀企图和治疗反应不佳有关,需要进一步研究其长期发展和最佳管理.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 遗传学 是一个遗传学.
背景情况:
- 快速循环双极性障碍 (RC-BD) 在患者护理方面存在重大挑战,原因是患病率增加和治疗效率降低.
- 了解RC-BD的精确定义,患病率和临床特征对于改善患者的治疗结果至关重要.
研究的目的:
- 系统地审查和综合现有关于快速循环双极障碍相关的定义,患病率,风险因素和临床结果的文献.
- 提供RC-BD的全面概述,以告知临床实践和指导未来的研究.
主要方法:
- 为了在2022年4月之前对RC-BD进行系统审查和元分析,进行了系统的文献搜索.
- 包括的研究使用NIH质量评估工具评估质量,使用牛津标准评估证据水平.
- 数据提取集中在30项涉及13,698名患者的研究中的定义,患病率,风险因素和临床结果上.
主要成果:
- 综合的RC-BD的一年患病率为22.3%,终身患病率为35.5%,在女性中观察到更高的终身患病率.
- 强有力的证据支持RC-BD与自杀企图之间的关联,以及对情绪稳定剂的不满意反应.
- 适度的证据将RC-BD与童年虐待,混合特征,女性性别和双极II障碍联系起来.
结论:
- 快速循环双极性障碍是一种普遍的疾病 (22.3%-35.5%),与较差的治疗结果和自杀企图风险增加有关.
- 已识别的风险因素,如女性性别,童年虐待和特定疾病表现,可以指导临床管理.
- 需要进一步研究长期疾病轨迹,代谢因素以及优化RC-BD治疗策略.
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