Should an assessment of Axis I comorbidity be included in the initial diagnostic assessment of mood disorders? Role of QIDS-16-SR total score in predicting number of Axis I comorbidity
Should an assessment of Axis I comorbidity be included in the initial diagnostic assessment of mood disorders? Role of QIDS-16-SR total score in predicting number of Axis I comorbidity
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DOI：
10.1016/j.jad.2012.12.004
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发表时间：
2013-06-01
影响因子：
6.6
通讯作者：
Calabrese, Joseph R.
中科院分区：
文献类型：
--
作者：
Gao, Keming;Wang, Zuowei;Calabrese, Joseph R.
背景：在流行病学研究中，心境障碍中的轴I共病是常见的。本研究旨在调查轴I共病的患病率、模式和数量，以及抑郁症状快速量表的作用- 16项自我报告（QIDS-16-SR）在预测重度抑郁症（MDD）或双相情感障碍（BPD）的共病数量中的作用。使用了前300例常规临床门诊患者的基线数据，这些患者通过BPD第5.0.0版的简明国际神经精神访谈系统治疗增强程序进行诊断。结果：在113例MDD和166例BPD患者中，焦虑障碍（AD）、物质使用障碍（SUD）和注意缺陷多动障碍（ADHD）的患病率分别为76%和74%、14%和29%、8%和21%。最常见的合并症类型为MDD+AD（58.4%），BPD+AD（39.8%）和BPD+AD+SUD（11.4%）。超过80%的MDD或BPD患者有>= 1种共病。大约20%的BPD患者和10%的MDD患者有≥ 4种其他疾病。在MDD和BPD中，合并症的数量与基线严重程度和自杀意念呈正相关。一个QIDS-16-SR为10有一个积极的预测值>= 90%，在预测>= 1合并症在MDD和BPD.Limitations：样本是适度的，从三级医疗center.Conclusion：一个彻底的诊断评估轴I合并症应包括在所有患者的情绪障碍，特别是当一个QIDS-16-SR>= 10点。(c)2012爱思唯尔有限公司版权所有。
Background: Axis I comorbidity in mood disorders was common in epidemiological studies. This study was designed to investigate the prevalence, pattern, and number of Axis I comorbidities and the role of the Quick Inventory of Depression Symptomatology - 16 items-Self-Report (QIDS-16-SR) in predicting the number of comorbidities in major depressive disorder (MDD) or bipolar disorder (BPD).Methods: Baseline data from the first 300 routine clinical outpatients diagnosed with the Mini International Neuropsychiatric Interview Systematic-Treatment-Enhancement - Program for BPD version 5.0.0 were used. Baseline severity was measured with QIDS-16-SR and Clinical Global Impression-Severity (CGI-S).Results: Of 113 patients with MDD and 166 with BPD, the prevalence of any current anxiety disorder (AD), substance use disorder (SUD), and attention deficit hyperactivity disorder (ADHD) was 76% versus 74%, 14% versus 29%, and 8% versus 21%, respectively. The most common patterns of current comorbidity were MDD+AD (58.4%) for MDD, and BPD+AD (39.8%) and BPD+AD+SUD (11.4%) for BPD. More than 80% patients with MDD or BPD had >= 1 current comorbid disorder. About 20% patients with BPD and 10% with MDD had >= 4 other disorders. The number of comorbidities was positively associated with baseline severity and suicidal ideation in both MDD and BPD. A QIDS-16-SR of 10 had a positive predictive value of >= 90% in predicting >= 1 comorbidity in MDD and BPD.Limitations: The sample was modest and from a tertiary medical center.Conclusion: A thorough diagnostic assessment for Axis I comorbidity should be included in all patients with mood disorders, especially when a QIDS-16-SR of >= 10 points. (c) 2012 Elsevier B.V. All rights reserved.