探索双相情感障碍的失用障碍:功能和生活质量的横断面分析

İpek Özönder Ünal
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Patients diagnosed with bipolar disorder 1, between 18 and 65 years of age, were included based on their diagnosis as determined by the Structured Clinical Interview for DSM-5 Clinical Version (SCID-5-CV). Their right-handedness was ascertained via the Edinburgh Handedness Inventory. To minimize the confounding effects of acute mood episodes on praxia deficits, patients were required to score below 5 on the Young Mania Rating Scale (YMRS) and 7 or lower on the 17-item Hamilton Depression Rating Scale (HDRS). This criterion ensured the exclusion of individuals experiencing an active mood episode. Additionally, participants needed to have been in remission for at least six months. Healthy controls, aged 18-65 and confirmed as right-handed, were included, provided they had no personal or familial history of psychiatric conditions. A detailed interview using SCID-5-CV confirmed that the healthy controls had no history or suspicion of bipolar disorder (BD) or any other psychiatric disorder and no relatives with a psychiatric disorder. All participants (203 bipolar disorder patients and 201 healthy controls) underwent evaluations using the Test for Upper Limb Apraxia (TULIA), while the bipolar cohort received the Global Functioning Assessment-Functioning (GAF-F) and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF). Statistical analyses were conducted using SPSS 22.0. Results: We identified a critical TULIA score threshold of 217, which differentiates bipolar patients from healthy individuals with a sensitivity of 79.3% and a specificity of 77.1% (area under the curve (AUC) 0.799, P<0.001). TULIA scores in bipolar patients were significantly positively correlated with functionality (GAF-F; r=0.502, P<0.001) and quality of life-general health (WHOQOL; r=0.389, P<0.001). 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引用次数: 0

摘要

背景/目的:双相情感障碍患者经常经历失用障碍,这可能会影响他们的功能和生活质量。本研究旨在深入研究这些患者的实践缺陷,将他们的实践表现与健康对照进行比较,并阐明实践表现、功能和生活质量之间的相互关系。方法:在这项于2023年2月至7月进行的横断面研究中,我们招募了203名诊断为双相情感障碍的患者。参与者是从Ibni Sina和Sifa社区精神卫生中心招募的,这两个中心都隶属于伊斯坦布尔图兹拉州立医院。此外,还招募了201名健康对照(HC),主要来自医院工作人员的朋友和亲属。诊断为双相情感障碍1的患者,年龄在18至65岁之间,根据DSM-5临床版结构化临床访谈(SCID-5-CV)确定的诊断纳入研究。他们的右利手性是通过爱丁堡利手性量表确定的。为了尽量减少急性情绪发作对失用症的混杂影响,要求患者在青年躁狂症评定量表(YMRS)上得分低于5分,在17项汉密尔顿抑郁评定量表(HDRS)上得分低于7分。这一标准确保排除了经历活跃情绪发作的个体。此外,参与者需要缓解至少6个月。健康对照组,年龄在18-65岁之间,确认为右撇子,前提是他们没有个人或家族精神病史。使用SCID-5-CV的详细访谈证实,健康对照者没有双相情感障碍(BD)或任何其他精神障碍病史或怀疑,也没有亲属患有精神障碍。所有参与者(203名双相情感障碍患者和201名健康对照者)使用上肢失用症测试(TULIA)进行评估,而双相情感障碍队列接受全球功能评估-功能(GAF-F)和世界卫生组织生命质量简短版本(WHOQOL-BREF)。采用SPSS 22.0进行统计学分析。结果:我们确定了一个临界TULIA评分阈值为217,该阈值将双相情感障碍患者与健康个体区分开来,灵敏度为79.3%,特异性为77.1%(曲线下面积(AUC) 0.799, P<0.001)。双相情感障碍患者的TULIA评分与功能显著正相关(GAF-F;r=0.502, P<0.001)和生活质量(WHOQOL;r = 0.389,术中;0.001)。TULIA哑剧评分(OR=0.92, 95% CI 0.86-0.99, P=0.022)和CPZ每天使用超过250mg (OR=2.24, 95% CI 1.19-4.21, P=0.012)是双相情感障碍患者功能障碍的独立预测因子。结论:双相情感障碍患者的失用障碍可能与影响其功能和生活质量的特定临床特征复杂相关。全面的失动症评估可以为设计量身定制的干预措施铺平道路,增强失动症,进而提高双相患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring praxia deficits in bipolar disorder: A cross-sectional analysis of functionality and quality of life
Background/Aim: Patients with bipolar disorder often experience praxia deficits, which might impede their functionality and quality of life. This study sought to delve into praxis defects in these patients, contrasting their praxia performance with healthy controls and illuminating the interrelation between praxia performance, functionality, and quality of life. Methods: In this cross-sectional study conducted from February to July 2023, we enrolled 203 patients diagnosed with bipolar disorder 1. Participants were recruited from the Ibni Sina and Sifa Community Mental Health Centers, both of which are affiliated with the Istanbul Tuzla State Hospital. Additionally, 201 healthy controls (HC) were recruited, primarily from the friends and relatives of the hospital staff. Patients diagnosed with bipolar disorder 1, between 18 and 65 years of age, were included based on their diagnosis as determined by the Structured Clinical Interview for DSM-5 Clinical Version (SCID-5-CV). Their right-handedness was ascertained via the Edinburgh Handedness Inventory. To minimize the confounding effects of acute mood episodes on praxia deficits, patients were required to score below 5 on the Young Mania Rating Scale (YMRS) and 7 or lower on the 17-item Hamilton Depression Rating Scale (HDRS). This criterion ensured the exclusion of individuals experiencing an active mood episode. Additionally, participants needed to have been in remission for at least six months. Healthy controls, aged 18-65 and confirmed as right-handed, were included, provided they had no personal or familial history of psychiatric conditions. A detailed interview using SCID-5-CV confirmed that the healthy controls had no history or suspicion of bipolar disorder (BD) or any other psychiatric disorder and no relatives with a psychiatric disorder. All participants (203 bipolar disorder patients and 201 healthy controls) underwent evaluations using the Test for Upper Limb Apraxia (TULIA), while the bipolar cohort received the Global Functioning Assessment-Functioning (GAF-F) and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF). Statistical analyses were conducted using SPSS 22.0. Results: We identified a critical TULIA score threshold of 217, which differentiates bipolar patients from healthy individuals with a sensitivity of 79.3% and a specificity of 77.1% (area under the curve (AUC) 0.799, P<0.001). TULIA scores in bipolar patients were significantly positively correlated with functionality (GAF-F; r=0.502, P<0.001) and quality of life-general health (WHOQOL; r=0.389, P<0.001). TULIA pantomime subscores (OR=0.92, 95% CI 0.86-0.99, P=0.022) and CPZ use of more than 250mg per day (OR=2.24, 95% CI 1.19-4.21, P=0.012) were independent predictors of impairment in functioning in bipolar patients. Conclusion: Praxia deficits in bipolar disorder patients may be intricately tied to specific clinical features that influence both their functionality and life quality. Comprehensive praxia deficit assessments can pave the way for devising tailored interventions, enhancing praxia and, by extension, the quality of life of bipolar patients.
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