| 张晓琳,宁秋芬,丁贺,等.基于社会心理特征、疾病特征分析双相情感障碍 Ⅰ型首发躁狂病人复发的危险因素[J].安徽医药,2025,29(12):2447-2452. |
| 基于社会心理特征、疾病特征分析双相情感障碍 Ⅰ型首发躁狂病人复发的危险因素 |
| The risk factors of relapse in first-episode manic patients with bipolar type Ⅰ disorder were analyzed based on psychosocial characteristics and disease characteristics |
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| DOI：10.3969/j.issn.1009-6469.2025.12.024 |
| 中文关键词: 双相情感障碍 躁狂 复发 社会心理特征 疾病特征 危险因素 预测模型 |
| 英文关键词: Bipolar disorder Mania Recurrence Social psychological characteristics Disease characteristics Risk factor Forecasting model |
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| 中文摘要: |
| 目的基于社会心理特征、疾病特征分析双相情感障碍 Ⅰ型首发躁狂病人复发的危险因素。方法选取 2020年 1月至 2023年 2月平顶山市精神病医院、信阳市精神病医院精神科收治的双相情感障碍 Ⅰ型首发躁狂病人进行研究， 183例双相情感障碍 Ⅰ型首发躁狂病人均在接受治疗后痊愈，回顾性整理病人临床资料，根据痊愈 1年后复发情况分为未复发组( 143例)和复发组( 40例)。分析两组双相情感障碍 Ⅰ型首发躁狂病人人口学资料、社会心理特征、疾病特征，通过 logistic回归分析法分析双相情感障碍 Ⅰ型首发躁狂病人复发的危险因素，据此构建回归模型并评价。结果 183例双相情感障碍 Ⅰ型首发躁狂病人治愈后随访 1年期间复发 40例，复发率为 21.86%(40/183)。多因素 logistic分析结果显示，有负性生活事件、有情感忽视、停药方式为迅速停药、心境稳定剂为单一心境稳定剂为双相情感障碍 Ⅰ型首发躁狂病人复发的危险因素( OR=1.68、1.92、2.26、 |
| 英文摘要: |
| Objective To analyze the risk factors of relapse in first-episode manic patients with bipolar type Ⅰ disorder based on psy-chosocial characteristics and disease characteristics.Methods First-episode manic patients with bipolar type Ⅰ disorder admitted tothe psychiatric department of Pingdingshan Psychiatric Hospital and the Xinyang Mental Hospital from January 2020 to February 2023were selected for the study, and all 183 first-episode manic patients with bipolar type Ⅰ disorder were cured after treatment. Clinicaldata of the patients were retrospectively reviewed, and they were divided into the non-recurrence group (143 cases) and the relapsegroup (40 cases) according to the recurrence status after 1 year of recovery. The demographic data, psychosocial characteristics and dis-ease characteristics of two groups of first-episode manic patients with bipolar Ⅰ disorder were analyzed, and the risk factors of relapse in first-episode manic patients with bipolar Ⅰ disorder were analyzed by logistic regression analysis; based on this, the regression mod-el was constructed and evaluated.Results Among 183 first-episode manic patients with bipolar type Ⅰ disorder, 40 relapsed during 1 year follow-up after cure, and the recurrence rate was 21.86% (40/183). Multivariate logistic analysis showed that negative life events,emotional neglect, rapid drug withdrawal and using a single mood stabilizer were risk factors for relapse in first-episode manic patients with bipolar type Ⅰ disorder (OR=1.68, 1.92, 2.26, 2.03, P<0.05). Multiple regression models were constructed using logistic regres-sion equation: logistic (P) =.5.414+ negative life events ×0.517+ emotional neglect × 0.652+ withdrawal mode being rapid withdrawal ×0.816+ mood stabilizer being single mood stabilizer ×0.706. ROC curve was drawn, which showed that the area under the curve (AUC)of the model for predicting relapse in first-episode manic patients with bipolar type Ⅰ disorder was 0.92 [95%CI: (0.87, 0.95)] (P< 0.05), and the sensitivity and specificity were 85.00% and 87.41%, respectively. The Hosmer-Lemeshow goodness of fit test showed χ2= 4.57, P=0.732, indicating that the model was effectively constructed.Conclusions First-episode manic patients with bipolar I disorder have relapse. Negative life events, emotional neglect, rapid drug withdrawal, and using a single mood stabilizer can increase the risk ofrecurrence of first-episode manic patients with bipolar type Ⅰ disorder. The regression model established based on this data has goodpredictive value and can serve as a basis for the development of clinical preventive measures. |
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