Screening for bipolar disorder in the community
Screening for bipolar disorder in the community
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DOI：
10.4088/jcp.v64n0111
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发表时间：
2003-01-01
影响因子：
5.3
通讯作者：
Wagner, KD
中科院分区：
文献类型：
--
作者：
Hirschfeld, RMA;Calabrese, JR;Wagner, KD
背景：我们的目标是估算美国普通人群中双相I型和双相II型障碍的阳性筛查率。
方法：将情绪障碍问卷（MDQ）——一种经过验证的双相I型和II型障碍筛查工具，发送给按人口统计学变量选取的代表美国成年人口的127800人样本。85358名18岁及以上的受试者（回复率为66.8%）返回了调查问卷且数据可用。在未回复者中，3404名在人口统计学上与2000年美国人口普查数据匹配的受试者完成了电话访谈，以评估无应答偏差。
结果：经加权以匹配2000年美国人口普查人口统计学特征后，双相I型和II型障碍的总体阳性筛查率为3.4%。在对无应答偏差进行调整后，该比率上升至3.7%。在双相I型或II型障碍筛查呈阳性的个体中，只有19.8%的人报告曾从医生处得到双相障碍的诊断，而31.2%的人报告得到单相抑郁症的诊断。另外49.0%的人报告未得到双相障碍或单相抑郁症的任何诊断。阳性筛查在年轻人和低收入家庭中更为常见。在筛查呈阳性的人群中，偏头痛、过敏、哮喘以及酗酒和吸毒的发生率显著更高。
结论：3.7%的MDQ阳性筛查率表明，近4%的美国成年人可能患有双相I型和II型障碍。年轻人和收入较低的个体患这种在很大程度上诊断不足的疾病的风险更高。
Background: Our goal was to estimate the rate of positive screens for bipolar I and bipolar II disorders in the general population of the United States.Method: The Mood Disorder Questionnaire (MDQ), a validated screening instrument for bipolar I and II disorders, was sent to a sample of 127,800 people selected to represent the U.S. adult population by demographic variables. 85,358 subjects (66.8% response rate) that were 18 years of age or above returned the survey and had usable data. Of the nonrespondents, 3404 subjects matched demographically to the 2000 U.S. Census data completed a telephone interview to estimate nonresponse bias.Results: The overall positive screen rate for bipolar I and II disorders, weighted to match the 2000 U.S. Census demographics, was 3.4%. When adjusted for the nonresponse bias, the rate rose to 3.7%. Only 19.8% of the individuals with positive screens for bipolar I or II disorders reported that they had previously received a diagnosis of bipolar disorder from a physician, whereas 31.2% reported receiving a diagnosis of unipolar depression. An additional 49.0% reported receiving no diagnosis of either bipolar disorder or unipolar depression. Positive screens were more frequent in young adults and low income house-holds. The rates of migraine, allergies, asthma, and alcohol and drug abuse were substantially higher among those with positive screens.Conclusion: The positive MDQ screen rate of 3.7% suggests that nearly 4% of American adults may suffer from bipolar I and II disorders. Young adults and individuals with lower income are at greater risk for this largely underdiagnosed disorder.