Treatment Delay and Excessive Substance Use in Bipolar Disorder
Treatment Delay and Excessive Substance Use in Bipolar Disorder
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DOI：
10.1097/nmd.0b013e3181ef3ef4
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发表时间：
2010-09-01
影响因子：
1.9
通讯作者：
Melle, Ingrid
中科院分区：
文献类型：
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作者：
Lagerberg, Trine Vik;Larsson, Sara;Melle, Ingrid
本研究的目的是调查治疗延迟和过度使用物质之间的关系。从住院和门诊精神科连续招募了151名双相情感障碍（BD）I和II型患者，并将其分类为原发性或继发性BD（无或有既往过量物质使用）。所有患者治疗延迟的预测因素，以及原发性BD患者随后过度使用药物的预测因素，均采用logistic回归分析进行研究。中位治疗延迟为2.0年（IQR 14.0）。BD II障碍、无终身精神病、首次接触专业精神病服务的年龄较高、原发性BD和过量使用药物的患者，长期治疗延迟的风险增加。在原发性BD中，男性、受教育时间较短和治疗延迟时间较长的患者发生过度使用药物的风险增加。既往过度使用药物的患者长期治疗延迟的风险降低。BD发作后过度使用药物的风险随着治疗延迟时间的延长而增加。
The aim of the present study was to investigate the relationship between treatment delay and excessive substance use. A total of 151 bipolar disorder (BD) I and II patients were consecutively recruited from in-and outpatient psychiatric units, and categorized as primary or secondary BD (without or with antecedent excessive substance use). Predictors of treatment delay among all patients, and predictors of subsequent excessive substance use among primary BD patients, were investigated with logistic regression analyses. The median treatment delay was 2.0 years (IQR 14.0). The risk of long treatment delays was increased in patients with BD II disorder, no lifetime psychosis, a higher age at first contact with specialized psychiatric services, primary BD, and excessive substance use. In primary BD, the risk for developing excessive substance use was increased in males, in patients with shorter education and longer treatment delays. Patients with antecedent excessive substance use had reduced risk of long treatment delays. The risk of developing excessive substance use after BD onset increased with longer treatment delays.