Comorbid anxiety and substance use disorders associated with a lower use of mood stabilisers in patients with rapid cycling bipolar disorder: a descriptive analysis of the cross-sectional data of 566 patients.
Comorbid anxiety and substance use disorders associated with a lower use of mood stabilisers in patients with rapid cycling bipolar disorder: a descriptive analysis of the cross-sectional data of 566 patients.
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DOI：
10.1111/j.1742-1241.2009.02284.x
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发表时间：
2010-02
影响因子：
2.6
通讯作者：
Calabrese JR
中科院分区：
文献类型：
--
作者：
Gao K;Kemp DE;Conroy C;Ganocy SJ;Findling RL;Calabrese JR
研究双相情感障碍伴或不伴焦虑障碍（AD）和/或物质使用障碍（SUD）患者的情绪稳定剂治疗。广泛的临床访谈和小型国际神经精神访谈被用来确定DSM-IV诊断的快速循环双相I（RCBDI）或II（RCBDII），SUD和AD。在入组4项类似临床试验的患者中，回顾性确定了躁狂/轻躁狂首次发作后使用情绪稳定剂的既往治疗状态（未用药、错误用药和正确用药）。适当时使用T检验和卡方/Fisher精确检验。在566例患者（RCBDI n = 320，RCBDII n = 246）中，46%有任何终生AD，67%有任何终生SUD，40%有任何近期SUD。总体而言，12%的患者未用药，37%的患者在首次躁狂/轻躁狂发作时用药不当，51%的患者正确用药。终生AD和近期SUD的存在与较少的情绪稳定剂治疗相关。无论是否存在AD（OR = 2.6）或近期是否存在SUD（OR = 2.8），RCBDI患者均比RCBDII患者（OR = 3.64）更有可能正确用药。终生AD和近期SUD的存在增加了RCBDI中误用药物的风险，比值比分别为1.8和1.9，但在RCBDII中没有。在RCBD患者的多发病队列中，51%的患者（64%的RCBDI和33%的RCDBII）在首次躁狂/轻躁狂发作后正确使用情绪稳定剂。AD和SUD的存在与RCBDI患者的用药错误风险增加相关，但与RCBDII无关。
To study mood stabiliser treatment in patients with bipolar disorder with or without anxiety disorders (ADs) and/or substance use disorders (SUDs). Extensive clinical interview and Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid cycling bipolar I (RCBDI) or II (RCBDII), SUDs and ADs. Previous treatment statuses with a mood stabiliser after the first onset of mania/hypomania (unmedicated, mismedicated and correctly medicated) were retrospectively determined in patients enrolled into four similar clinical trials. T-test and chi-square/Fisher’s exact were used wherever appropriate. Of 566 patients (RCBDI n = 320, RCBDII n = 246), 46% had any lifetime AD, 67% had any lifetime SUD and 40% had any recent SUD. Overall, 12% of patients were unmedicated, 37% were mismedicated at the onset of first mania/hypomania and 51% were correctly medicated. Presence of lifetime ADs and recent SUDs was associated with fewer mood stabiliser treatments. Patients with RCBDI were more likely correctly medicated than those with RCBDII (OR = 3.64) regardless of the presence (OR = 2.6) or absence (OR = 4.2) of ADs, or the presence (OR = 2.8) or absence (OR = 3.13) of recent SUDs. Presence of lifetime ADs and recent SUDs increased the risk for mismedicated in RCBDI with odds ratios of 1.8 and 1.9, respectively, but not in RCBDII. In this multi-morbid cohort of patients with RCBD, 51% of patients (64% of RCBDI and 33% with RCDBII) were correctly medicated with a mood stabiliser after the onset of first mania/hypomania. The presence of ADs and SUDs was associated with an increased risk of mismedicated in patients with RCBDI, but not with RCBDII.
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影响因子：
3.8
作者：
Baldessarini, Ross J.;Leahy, Leslie;Hennen, John
通讯作者：
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影响因子：
3.8
作者：
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通讯作者：
Bowden, CL
影响因子：
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作者：
Birnbaum, HG;Shi, LZ;Mallett, DA
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Mallett, DA
影响因子：
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作者：
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通讯作者：
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影响因子：
6.6
作者：
Bauer, MS;Altshuler, L;Hauger, R
通讯作者：
Hauger, R