谁会过渡到双相情感障碍? 大型抑郁症,焦虑症和ADHD的比较
Kevin Li1, Katrina M Rodriguez2, Peter Zandi3
1Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Journal of affective disorders
|November 14, 2024
概括
最初被诊断为患有重度抑郁症 (MDD),焦虑症或多动症的患者,过渡到双极性障碍 (BD) 的几率各不相同. 长期抑郁症的风险最高,年龄和治疗环境等特定因素影响了转化.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 临床流行病学临床流行病学
- 电子健康记录研究研究 电子健康记录
背景情况:
- 双极性障碍 (BD) 的诊断延迟是常见的,影响患者的结果.
- 焦虑症和注意力缺陷多动症 (ADHD) 是常见的初始诊断,与主要抑郁症 (MDD) 一起.
- 从这些前体诊断中了解转化率对于及时干预至关重要.
研究的目的:
- 量化转化率从MDD,焦虑障碍和ADHD到BD.
- 为了确定与这种诊断过渡相关的相关性和风险因素.
- 使用大型EHR数据集,比较不同前体诊断的转化动态.
主要方法:
- 来自约翰霍普金斯医学院的十年电子健康记录 (EHR) 数据集的分析.
- 对初步诊断为MDD,焦虑障碍和ADHD的患者的转化率和风险因素的评估.
- 利用带有时间变量的比例危险模型来分析风险因素.
主要成果:
- 在21,341名患者中,1232人过渡到BD.
- 经过调整的十年转化率:MDD (11.4%),焦虑症 (9.4%),多动症 (10.9%).
- 年龄较小 (19-29岁),急诊/住院环境和精神药物与转化有关;严重/精神病性MDD是一个强有力的预测因素. 在成年人中,ADHD转化风险显著增加.
结论:
- 大型抑郁症 (MDD) 具有过渡到双极性障碍 (BD) 的最高风险.
- 焦虑障碍和成人多动症也对BD转化具有显著的风险.
- 过渡率和风险因素各不相同,ADHD显示成年人与儿童相比转化风险更高.
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