Substance Use Disorders as Risk Factors for Psychiatric Hospitalization in Bipolar Disorder
Substance Use Disorders as Risk Factors for Psychiatric Hospitalization in Bipolar Disorder
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DOI：
10.1176/appi.ps.60.1.50
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发表时间：
2009-01-01
影响因子：
3.8
通讯作者：
Brooks, John O., III
中科院分区：
文献类型：
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作者：
Hoblyn, Jennifer C.;Balt, Steve L.;Brooks, John O., III
目的：本研究为诊断为双相情感障碍的退伍军人制定了精神病住院的风险概况。研究方法：这项研究包括2,963名退伍军人被诊断为患有双相情感障碍（I型，II型，或未另行说明）在2004财政年度。数据来自退伍军人事务部行政数据库。精神病住院的风险概况与迭代应用程序的受试者操作特性。结果：在这个样本中，20%的双相情感障碍患者在一年的研究期间住院精神科。被诊断为酒精使用障碍和多种物质依赖的患者，以及与配偶或伴侣分离的患者，精神病住院的风险为100%;如果患者不与伴侣分离，精神病住院的风险降低至52%。没有被诊断为酒精使用障碍或多种物质依赖的患者，以及没有与伴侣分开的患者，其精神病住院的风险最低（12%）。在精神病住院患者中，41%的患者住院时间较长（> 14天），住院时间较长的最强预测因素是年龄超过77岁，这意味着77%的风险。结论：酒精使用和多种物质依赖可以显著影响双相情感障碍的病程，这一点可以通过其与精神病住院的相关性得到证明。增加对双相情感障碍老年人药物滥用的关注可能会减少精神病住院时间。我们的研究结果表明，在双相情感障碍的早期实施物质治疗计划可以减少卫生服务的使用。（精神病学服务60：50-55，2009）
Objective: This study developed risk profiles of psychiatric hospitalization for veterans diagnosed as having bipolar disorder. Methods: This study included 2,963 veterans diagnosed as having bipolar disorder (types I, II, or not otherwise specified) during the 2004 fiscal year. Data were derived from the Veterans Affairs administrative database. Risk profiles for psychiatric hospitalization were generated with an iterative application of the receiver operating characteristic. Results: In this sample 20% of the patients with bipolar disorder were hospitalized psychiatrically during the one-year study period. Patients diagnosed as having both an alcohol use disorder and polysubstance dependence and who also were separated from their spouse or partner had a 100% risk of psychiatric hospitalization; risk of psychiatric hospitalization decreased to 52% if the patients were not separated from their partner. Patients who were not diagnosed as having alcohol use disorders or polysubstance dependence and who were not separated from their partners exhibited the lowest risk of psychiatric hospitalization (12%). Among patients with a psychiatric hospitalization, 41% had longer lengths of stay (> 14 days), with the strongest predictor of a longer length of stay being an age older than 77 years, which conferred a 77% risk. Conclusions: Alcohol use and polysubstance dependence can significantly affect the course of bipolar disorder, as evidenced by their associations with psychiatric hospitalizations. Increased focus on substance abuse among older adults with bipolar disorder may decrease length of psychiatric hospitalization. Our findings suggest that implementing substance treatment programs early in the course of bipolar disorder could reduce health service use. (Psychiatric Services 60: 50-55, 2009)