摘要

目的 探索双相情感障碍患者混合发作情况并分析其影响因素。

方法 利用连续采样法，选取2013年2月至2014年6月就诊于中国7家医院门诊的520例双相情感障碍患者，并进行随访调查，收集其人口学资料、病史信息、疾病特征及治疗情况等临床资料，考察双相情感障碍混合发作情况，并通过泊松回归模型分析其影响因素。

结果 在520例双相情感障碍患者中，混合发作占75例（14.42%），其中I型72例，Ⅱ型3例。且泊松回归模型分析显示，双相情感障碍混合发作的危险因素包括：Ⅰ型患者较Ⅱ型混合发作次数多（IRR = 0.068，p＜0.001）；有精神疾病家族史的患者混合发作次数较多（IRR = 1.435，p = 0.037）；首次发作极性为非躁狂的患者较躁狂患者混合发作次数多（IRR = 9.988，p＜0.001）；首次发作极性为非抑郁的患者较抑郁患者混合发作次数多（IRR = 6.241，p＜0.001）；服用心境稳定剂的患者混合发作次数较多（IRR = 0.561，p = 0.001）。

结论 双相情感障碍患者混合发作次数与双相障碍分型、精神疾病家族史、首次发作极性以及是否使用心境稳定剂密切相关。

关键词：双相情感障碍；混合发作；影响因素

ABSTRACT

Objective To explore the mixed episodes of bipolar disorder and analyze its influencing factors.

Methods During February 2013 to June 2014, 520 patients with bipolar disorder were selected from 7 hospitals in China by continuous sampling method. The demographic data, medical history information, disease characteristics, treatment and other clinical data were collected. We investigated the number of mixed episodes of bipolar disorder and analyzed the influencing factors by Poisson regression model.

Results Among 520 patients with bipolar disorder, 75 cases (14.42%) were mixed episodes, including 72 cases type I and 3 cases type II. Poisson regression model analysis showed that the risk factors of mixed episodes included: Type I patients had more episodes than type II (IRR =0.068, p < 0.001). Patients with family history of mental illness had more mixed episodes (IRR =1.435, p=0.037). Patients with non-manic polarity at first episode had more mixed episodes than manic patients (IRR =9.988, p < 0.001). Non-depressed patients at first episode had more episodes than depressed patients (IRR =6.241, p < 0.001). Patients taking mood stabilizers had more mixed episodes (IRR =0.561, p=0.001).

Conclusion   Mixed episodes of bipolar disorder are closely related to the type of bipolar disorder, family history of mental illness, polarity of first episode and use of mood stabilizers.

Key words: Bipolar disorder; Mixed episodes; Influencing factor