Bipolar disorder: Trimodal age-at-onset distribution.
Bipolar disorder: Trimodal age-at-onset distribution.
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DOI：
10.1111/bdi.13016
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发表时间：
2021-06
影响因子：
5.4
通讯作者：
Saunders KEA
中科院分区：
文献类型：
--
作者：
Bolton S;Warner J;Harriss E;Geddes J;Saunders KEA
双相情感障碍（BD）是一种慢性精神健康障碍，具有显着的发病率和死亡率。发病年龄 (AAO) 可能是描述 BD 患者更同质亚组的关键变量。然而，尚无已知研究系统评估如何定义 BD 发病年龄亚组。我们系统地检索了以下数据库：Cochrane Central Register of Controlled Trials、PsycINFO、MEDLINE、Embase、CINAHL、Scopus、Proquest Dissertations andTheses、Google Scholar 和 BIOSIS Previews。寻求调查 BD 中 AAO 的原始定量英语语言研究。总共确定了 9454 种独特的出版物。其中 21 人被纳入数据分析（n = 22981 BD 参与者）。其中 14 项研究（67%，n = 13626 名受试者）发现了三峰 AAO 分布：早发（μ = 17.3，σ = 1.19，样本的 45%）、中期发病（μ = 26.0，= 1.72，35%）和晚发（μ = 41.9，= 6.16，20%）。五项研究（24%，n = 1422 名参与者）描述了双峰 AAO 分布：早发（μ = 24.3，σ = 6.57，样本的 66%）和晚发（μ = 46.3，σ = 14.15，34%）。两项研究调查了 BD AAO 的群组效应，发现当样本不按群组划分时，三峰 AAO 是获胜模型，但当按群组划分时，双峰分布更适合数据。我们建议该领域将双相情感障碍的发病年龄亚组概念化为广泛的生命阶段。划分 BD AAO 组可以为治疗提供信息，并为未来研究提供框架，以继续研究疾病发病的潜在机制。
Bipolar disorder (BD) is a chronic mental health disorder with significant morbidity and mortality. Age at onset (AAO) may be a key variable in delineating more homogeneous subgroups of BD patients. However, no known research has systematically assessed how BD age‐at‐onset subgroups should be defined. We systematically searched the following databases: Cochrane Central Register of Controlled Trials, PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Proquest Dissertations and Theses, Google Scholar and BIOSIS Previews. Original quantitative English language studies investigating AAO in BD were sought. A total of 9454 unique publications were identified. Twenty‐one of these were included in data analysis (n = 22981 BD participants). Fourteen of these studies (67%, n = 13626 participants) found a trimodal AAO distribution: early‐onset (µ = 17.3, σ = 1.19, 45% of sample), mid‐onset (µ = 26.0, = 1.72, 35%), and late‐onset (µ = 41.9, = 6.16, 20%). Five studies (24%, n = 1422 participants) described a bimodal AAO distribution: early‐onset (µ = 24.3, σ = 6.57, 66% of sample) and late‐onset (µ = 46.3, σ = 14.15, 34%). Two studies investigated cohort effects on BD AAO and found that when the sample was not split by cohort, a trimodal AAO was the winning model, but when separated by cohort a bimodal distribution fit the data better. We propose that the field conceptualises bipolar disorder age‐at‐onset subgroups as referring broadly to life stages. Demarcating BD AAO groups can inform treatment and provide a framework for future research to continue to investigate potential mechanisms of disease onset.
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