摘要
目的探讨双相Ⅰ型障碍(BP-Ⅰ)躁狂发作患者临床特征及复发的影响因素。方法选取2020年6月—2023年6月平顶山市精神病医院收治的BP-Ⅰ躁狂发作患者98例作为本次实验对象。对其开展为期半年的随访,根据患者是否复发将其分为复发组(n=37)和未复发组(n=61)。比较两组一般资料和相关量表评分,通过logistic回归模型作多因素分析用以明确影响BP-Ⅰ躁狂发作患者复发的独立影响因素,经ROC曲线评估诊断效能。结果两组在病程、是否维持治疗、使用心境稳定剂情况方面比较差异明显(P<0.05);与未复发组相比较,复发组杨氏狂躁量表(YMRS)、汉密顿抑郁量表(HAMD-17)评分较高,自知力和治疗态度问卷(ITAQ)、家庭亲密度和适应性量表(FACESⅡ-CV)评分较低(P<0.05);经logistic回归模型多因素分析,是否维持治疗(P=0.008,OR=5.202)、使用心境稳定剂情况(P=0.000,OR=3.473)、YMRS(P=0.005,OR=1.370)、HAMD-17(P=0.009,OR=1.221)、ITAQ(P=0.000,OR=1.694)、FACESⅡ-CV评分(P=0.006,OR=1.074)是BP-I躁狂发作患者复发的独立影响因素;由ROC曲线分析,经构建风险评估模型(即是否维持治疗、使用心境稳定剂情况、YMRS、HAMD-17、ITAQ、FACESⅡ-CV评分联合检测模式下)AUC值最高,为0.910,且灵敏度、特异度分别为94.59%、89.18%。结论是否维持治疗、使用心境稳定剂情况、YMRS、HAMD-17、ITAQ、FACESⅡ-CV评分是BP-Ⅰ躁狂发作患者复发的独立影响因素。在临床上应控制相关因素,并给予有效的干预措施来降低BP-Ⅰ躁狂发作患者复发的风险。
Objective To investigate the clinical features and the factors affecting relapse of bipolar typeⅠdisorder(BP-Ⅰ)patients with manic episodes.Methods Ninety-eight patients with BP-Ⅰmanic episode admitted to Pingdingshan Psychiatric Hospital from June 2020 to June 2023 were selected as the subjects of this experiment.The patients were followed up for half a year and were divided into relapse group(n=37)and non-recurrence group(n=61)according to whether they relapsed or not.The general data and relevant scale scores of the two groups were compared,and multivariate analysis was performed in the logistic regression model to identify the independent factors affecting the recurrence of BP-Ⅰ patients with manic episodes,and the diagnostic efficacy was evaluated by ROC curve.Results There were significant differences between the two groups in the course of disease,whether to maintain treatment and the use of mood stabilizer(P<0.05).Compared with the non-recurrence group,the scores of YMRS and HAMD-17 in the recurrence group were higher,and the scores of ITAQ and FACESⅡ-CV were lower(P<0.05).Multivariate analysis of logistic regression model showed whether or not to maintain treatment(P=0.008,OR=5.202),use of mood stabilizers(P=0.000,OR=3.473),YMRS(P=0.005,OR=1.370),HAMD-17(P=0.009,OR=1.221),ITAQ(P=0.000,OR=1.694),FACESⅡ-CV score(P=0.006,OR=1.074)were the independent influencing factors of relapse in BP-Ⅰpatients with manic episode.Based on ROC curve analysis,the risk assessment model(i.e.whether treatment was maintained,mood stabilizer use,YMRS,HAMD-17,ITAQ,FACESⅡ-CV score combined detection mode)had the highest AUC value,which was 0.910,and the sensitivity and specificity were 94.59% and 89.18%,respectively.Conclusion Maintenance of treatment,mood stabilizer use,YMRS,HAMD-17,ITAQ,FACESⅡ-CV score are independent factors of relapse in BP-Ⅰ patients with manic episode.Clinically,relevant factors should be controlled and effective interventions should be given to reduce the risk of relapse in patients with
作者
李素真
张晓彬
刘广胜
LI Su-zhen;ZHANG Xiao-bin;LIU Guang-sheng(Department of Psychiatry,Pingdingshan Psychiatric Hospital,Pingdingshan,Henan 467000,China)
出处
《医药论坛杂志》
2024年第7期694-698,共5页
Journal of Medical Forum
关键词
双相情感障碍Ⅰ型
躁狂发作
复发
影响因素
Bipolar disorder type Ⅰ
Manic episodes
Recurrence
Influencing factor
