Medical comorbidity in women and men with bipolar disorders: A population-based controlled study
Medical comorbidity in women and men with bipolar disorders: A population-based controlled study
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DOI：
10.1097/01.psy.0000237316.09601.88
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发表时间：
2006-09-01
影响因子：
3.3
通讯作者：
Jones, Laura E.
中科院分区：
文献类型：
--
作者：
Carney, Caroline P.;Jones, Laura E.
目的：很少有关于双相情感障碍患者慢性合并症的经过验证的信息。为了提供适当的卫生服务，了解该人群慢性疾病的患病率非常重要。本研究使用经过验证的方法检查双相情感障碍患者的慢性医学合并症。方法：这是对 Wellmark Blue Cross Blue Shield 的 100% 行政索赔样本（1996-2001 年）进行的回顾性研究。三千五百五十七名受试者患有 I 型双相情感障碍，但没有声称患有精神分裂症或分裂情感性障碍。对照组没有任何关于精神疾病的书面声明。使用经过验证的方法，住院和门诊索赔被用来确定 44 种慢性疾病的患病率。根据年龄、性别、居住地和非精神医疗保健利用率对优势比 (OR) 进行调整。结果：与对照组相比，双相情感障碍患者较年轻（平均年龄 38.8 岁），并且更容易患有医学合并症，包括三种或更多慢性病（41% 对比 12%，p < .001）。跨所有器官系统的病症均发现 OR 升高。高脂血症、淋巴瘤和转移性癌症是双相情感障碍患者中唯一不太可能发生的疾病。结论：双相情感障碍与大量的慢性医疗负担相关。熟悉影响这一人群的状况可能有助于旨在为慢性精神疾病患者提供医疗护理的计划。
Objective: Rarely has validated information on chronic medical comorbidity been presented for persons with bipolar disorder. To deliver appropriate health services, it is important to understand the prevalence of chronic medical conditions in this population. This study examines chronic medical comorbidity using validated methodology in persons with bipolar disorder. Methods: This is a retrospective study of a 100% sample of administrative claims (1996-2001) from Wellmark Blue Cross Blue Shield. Three thousand five hundred fifty-seven subjects had bipolar I disorder and did not have claims for schizophrenia or schizoaffective disorder. Controls had no documented claims for psychiatric conditions. Using validated methodology, inpatient and outpatient claims were used to determine prevalence of 44 chronic medical conditions. Odds ratios (ORs) were adjusted for age, gender, residence, and nonmental healthcare utilization. Results: Persons with bipolar disorder were young (mean age, 38.8 years) and significantly more likely to have medical comorbidity, including three or more chronic conditions (41% versus 12%, p < .001) compared with controls. Elevated ORs were found for conditions spanning all organ systems. Hyperlipidemia, lymphoma, and metastatic cancer were the only conditions less likely to occur in persons with bipolar disorder. Conclusion: Bipolar disorders are associated with substantial chronic medical burden. Familiarity with conditions affecting this population may assist in programs aimed at providing medical care for the chronically mentally ill.