An epidemiological study of externally determined and self-identified mental and physical disability across the spectrum of bipolar disorders
An epidemiological study of externally determined and self-identified mental and physical disability across the spectrum of bipolar disorders
复制标题
DOI：
10.1016/j.jad.2021.07.085
复制
发表时间：
2021-07-28
影响因子：
6.6
通讯作者：
Murray, Greg
中科院分区：
文献类型：
--
作者：
Scott, Jan;Morton, Emma;Murray, Greg
背景：探索双相情感障碍（BD）残疾的研究主要评估了全阈值BD-I和BD-II的临床样本，以及所谓的客观标准，如失业或接受政府残疾补助。本研究通过在社区样本中检查外部确定和自我确定的残疾并通过包括阈下BD（BDS）来扩展对残疾的研究。方法：数据提取自美国协作精神病学流行病学调查，该调查涉及符合BD-I，BD-II和BDS公认标准的个人，他们完成了身体和精神残疾，合并症和健康风险因素的自我评级（例如，肥胖症）。残疾率进行了估计，并进行逻辑回归分析，以确定人口统计学和临床变量与外部确定和自我认定的残疾。（BD-I = 100; BD-II=104; BDS=204），35%符合外部确定的残疾标准，约40%自报精神残疾，约23%自报身体残疾。优势是三倍（优势比（OR）：3.05; 95%置信区间（CI）：1.69，5.53），自我认定的身体残疾的人将符合外部确定的残疾标准，但与精神残疾的关联是不显着的（OR：1.06; 95% CI：0.63，1.80）。回归分析表明，精神残疾与当前或过去的吸烟者和身体残疾与BD-I.限制：：残疾和BDS的定义的评估的充分性可以质疑。结论：：未来的临床和社区研究需要考虑外部确定和自我识别的残疾在整个BD频谱。
Background:: Studies exploring disability in bipolar disorder (BD) have primarily assessed clinical samples of full-threshold BD-I and BD-II alongside so-called objective criteria such as unemployment or receipt of government disability payments. This study extends research on disability by examining externally determined and self-identified disability in a community sample and by including subthreshold BD (BDS).Methods:: Data were extracted from the USA Collaborative Psychiatric Epidemiology Surveys about individuals who met recognized criteria for BD-I, BD-II and BDS who had completed self-ratings of physical and mental disability, comorbidities, and health risk factors (e.g., obesity). Rates of disability were estimated, and logistic regression analyses were used to determine demographic and clinical variables associated with externally determined and self-identified of disability.Results: : Of 408 individuals who met eligibility criteria (BD-I = 100; BD-II=104; BDS=204), 35% met criteria for externally determined disability, about 40% self-reported mental disability and about 23% self-reported physical disability. The odds were three-fold (Odds Ratio (OR): 3.05; 95% Confidence Intervals (CI): 1.69, 5.53) that someone with self-identified physical disability would meet criteria for externally determined disability, but associations with mental disability were non-significant (OR: 1.06; 95% CI: 0.63, 1.80). Regression analyses demonstrated that mental disability was associated with being a current or past smoker and physical disability was associated with BD-I.Limitations:: the adequacy of the assessments of disability and definition of BDS can be questioned.Conclusions: : Future clinical and community studies need to consider both externally determined and selfidentified disability across the entire Bd spectrum.