双相情感障碍患者的职业功能障碍和入院情况与不同多基因图谱的关系

IF 15.1 1区 医学 Q1 PSYCHIATRY
American Journal of Psychiatry Pub Date : 2024-07-01 Epub Date: 2024-06-11 DOI:10.1176/appi.ajp.20230073
Lina Jonsson, Elin Hörbeck, Amedeo Primerano, Jie Song, Robert Karlsson, Erik Smedler, Katherine Gordon-Smith, Lisa Jones, Nicholas Craddock, Ian Jones, Patrick F Sullivan, Erik Pålsson, Arianna Di Florio, Timea Sparding, Mikael Landén
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引用次数: 0

摘要

目的:许多但并非所有双相情感障碍患者都因严重的情绪发作而需要住院治疗。同样,一些患者(但并非所有患者)在急性情绪发作后会出现长期的职业功能障碍。目前尚不清楚躁郁症的这些不同结果是否是由不同的多基因谱驱动的。在此,我们评估了主要精神障碍和教育程度的多基因评分(PGSs)与双相情感障碍患者的职业功能和精神病院入院率之间的关系:共对 4782 名躁狂症患者和 2963 名对照组受试者进行了基因分型,并与瑞典国家登记册进行了关联。通过对至少 10 年的登记数据进行纵向测量,得出无工作年数的百分比、休长期病假年数的百分比以及每年入住精神病院的平均次数。采用序数回归法检验双相情感障碍、精神分裂症、重度抑郁障碍、注意缺陷多动障碍 (ADHD) 和受教育程度等结果与 PGS 之间的关联。利用躁郁症研究网络队列(N=4,219)的数据对入院情况进行了重复分析:结果:双相情感障碍患者的长期病假和失业与精神分裂症、多动症、重度抑郁障碍和教育程度的 PGS 显著相关,但与双相情感障碍的 PGS 无关。相比之下,每年入院次数与双相情感障碍和精神分裂症的 PGS 值较高有关,但与其他 PGS 值无关:结论:躁郁症的严重程度(以入院次数为指标)与长期职业功能障碍的多基因特征不同。这些发现具有临床意义,表明减轻职业功能障碍需要采取干预措施,而不是为预防情绪发作而采取的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of Occupational Dysfunction and Hospital Admissions With Different Polygenic Profiles in Bipolar Disorder.

Objective: Many but not all persons with bipolar disorder require hospital care because of severe mood episodes. Likewise, some but not all patients experience long-term occupational dysfunction that extends beyond acute mood episodes. It is not known whether these dissimilar outcomes of bipolar disorder are driven by different polygenic profiles. Here, polygenic scores (PGSs) for major psychiatric disorders and educational attainment were assessed for associations with occupational functioning and psychiatric hospital admissions in bipolar disorder.

Methods: A total of 4,782 patients with bipolar disorder and 2,963 control subjects were genotyped and linked to Swedish national registers. Longitudinal measures from at least 10 years of registry data were used to derive percentage of years without employment, percentage of years with long-term sick leave, and mean number of psychiatric hospital admissions per year. Ordinal regression was used to test associations between outcomes and PGSs for bipolar disorder, schizophrenia, major depressive disorder, attention deficit hyperactivity disorder (ADHD), and educational attainment. Replication analyses of hospital admissions were conducted with data from the Bipolar Disorder Research Network cohort (N=4,219).

Results: Long-term sick leave and unemployment in bipolar disorder were significantly associated with PGSs for schizophrenia, ADHD, major depressive disorder, and educational attainment, but not with the PGS for bipolar disorder. By contrast, the number of hospital admissions per year was associated with higher PGSs for bipolar disorder and schizophrenia, but not with the other PGSs.

Conclusions: Bipolar disorder severity (indexed by hospital admissions) was associated with a different polygenic profile than long-term occupational dysfunction. These findings have clinical implications, suggesting that mitigating occupational dysfunction requires interventions other than those deployed to prevent mood episodes.

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来源期刊
American Journal of Psychiatry
American Journal of Psychiatry 医学-精神病学
CiteScore
22.30
自引率
2.80%
发文量
157
审稿时长
4-8 weeks
期刊介绍: The American Journal of Psychiatry, dedicated to keeping psychiatry vibrant and relevant, publishes the latest advances in the diagnosis and treatment of mental illness. The journal covers the full spectrum of issues related to mental health diagnoses and treatment, presenting original articles on new developments in diagnosis, treatment, neuroscience, and patient populations.
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