Prevalence and correlates of manic/hypomanic and depressive predominant polarity in bipolar disorder: systematic review and meta-analysis.

IF 3.9 3区医学 Q1 PSYCHIATRY

BJPsych Open Pub Date : 2024-05-06 DOI:10.1192/bjo.2024.51

Francesco Bartoli, Carlo Bassetti, Marco Gazzola, Letizia Gianfelice, Daniele Cavaleri, Cristina Crocamo, Giuseppe Carrà

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引用次数: 0

Abstract

Background: Identification of the predominant polarity, i.e. hypomanic/manic (mPP) or depressive predominant polarity (dPP), might help clinicians to improve personalised management of bipolar disorder.

Aims: We performed a systematic review and meta-analysis to estimate prevalence and correlates of mPP and dPP in bipolar disorder.

Method: The protocol was registered in the Open Science Framework Registries (https://doi.org/10.17605/OSF.IO/8S2HU). We searched main electronic databases up to December 2023 and performed random-effects meta-analyses of weighted prevalence of mPP and dPP. Odds ratios and weighted mean differences (WMDs) were used for relevant correlates.

Results: We included 28 studies, providing information on rates and/or correlates of mPP and dPP. We estimated similar rates of mPP (weighted prevalence = 30.0%, 95% CI: 23.1 to 37.4%) and dPP (weighted prevalence = 28.5%, 95% CI: 23.7 to 33.7%) in bipolar disorder. Younger age (WMD = -3.19, 95% CI: -5.30 to -1.08 years), male gender (odds ratio = 1.39, 95% CI: 1.10 to 1.76), bipolar-I disorder (odds ratio = 4.82, 95% CI: 2.27 to 10.24), psychotic features (odds ratio = 1.56, 95% CI: 1.01 to 2.41), earlier onset (WMD = -1.57, 95% CI: -2.88 to -0.26 years) and manic onset (odds ratio = 13.54, 95% CI: 5.83 to 31.46) were associated with mPP (P < 0.05). Depressive onset (odds ratio = 12.09, 95% CI: 6.38 to 22.90), number of mood episodes (WMD = 0.99, 95% CI: 0.28 to 1.70 episodes), history of suicide attempts (odds ratio = 2.09, 95% CI: 1.49 to 2.93) and being in a relationship (odds ratio = 1.98, 95% CI: 1.22 to 3.22) were associated with dPP (P < 0.05). No differences were estimated for other variables.

Conclusions: Despite some limitations, our findings support the hypothesis that predominant polarity might be a useful specifier of bipolar disorder. Evidence quality was mixed, considering effects magnitude, consistency, precision and publication bias. Different predominant polarities may identify subgroups of patients with specific clinical characteristics.

查看原文本刊更多论文

双相情感障碍中躁狂/躁狂和抑郁主导极性的发生率和相关性：系统回顾和荟萃分析。

背景：目的：我们进行了一项系统综述和荟萃分析，以估算双相情感障碍中 mPP 和 dPP 的患病率和相关性：该方案已在开放科学框架注册中心（https://doi.org/10.17605/OSF.IO/8S2HU）注册。我们检索了截至 2023 年 12 月的主要电子数据库，并对 mPP 和 dPP 的加权患病率进行了随机效应荟萃分析。对相关的关联因素采用了比值比和加权平均差（WMD）：我们纳入了 28 项研究，这些研究提供了有关 mPP 和 dPP 发病率和/或相关因素的信息。我们估计双相情感障碍患者的 mPP（加权患病率=30.0%，95% CI：23.1% 至 37.4%）和 dPP（加权患病率=28.5%，95% CI：23.7% 至 33.7%）患病率相似。年龄较小（WMD = -3.19，95% CI：-5.30 至 -1.08 岁）、性别为男性（几率比 = 1.39，95% CI：1.10 至 1.76）、躁郁症（几率比 = 4.82，95% CI：2.27 至 10.24）、精神病特征（几率比 = 1.56，95% CI：1.01 至 2.41）、较早发病（WMD =-1.57，95% CI：-2.88 至-0.26 年）和躁狂发病（几率比 = 13.54，95% CI：5.83 至 31.46）与 mPP 相关（P <0.05）。抑郁发作（几率比 = 12.09，95% CI：6.38 至 22.90）、情绪发作次数（WMD = 0.99，95% CI：0.28 至 1.70 次）、自杀未遂史（几率比 = 2.09，95% CI：1.49 至 2.93）和恋爱关系（几率比 = 1.98，95% CI：1.22 至 3.22）与 dPP 相关（P < 0.05）。其他变量没有差异：尽管存在一些局限性，但我们的研究结果支持这样的假设，即占优势的极性可能是双相情感障碍的一个有用指标。考虑到效应大小、一致性、精确性和发表偏倚，证据质量参差不齐。不同的主导极性可识别具有特定临床特征的亚组患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BJPsych Open Medicine-Psychiatry and Mental Health

CiteScore

6.30

自引率

3.70%

发文量

610

审稿时长

16 weeks

期刊介绍： Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.