Investigation Of Comorbidity In Bipolar Disorder And Half-A-Year Follow-Up Study

Objective:Bipolar disorder is a common psychiatric disease with high incidence rate, high disability rate and high misdiagnosis rate, which makes the picture of bipolar disorder more complicated and more serious, and the misdiagnosis rate higher. The article aimed to investigate the comorbidity rates of patients with bipolar disorder, to compare the differences of patients with and without bipolar disorder in such aspects as disease characteristics, severity, clinical effects and damage to social functions, and to explore the influences of comorbidity on bipolar disorder in the clinical characteristics, clinical effects and social function of the disease. So then, the results provided reference for clinical diagnosis and treatment and comprehensive intervention in patients with bipolar disorder.Object and Method:Retrospective cohort study were adopted, and 161 cases of inpatients with bipolar disorder in Zaozhuang Mental Health Center were taken as research objects from Jan 1,2014 to Dec 31,2014.The questionnaires of the general conditions and clinical comorbidity diagnosis in the research subjects were conducted according to the ICD-10 diagnostic criteria; according to whether there is a comorbidity, the patients were divided into comorbidity and non comorbidity groups, assessments of severity of illness scale (CGI) and Social Disability Screening Schedule (SDSS) were conducted before treatment and at end of 3 months and 6 months after treatment respectively; finally the above indicators were analyzed.Results:1.The total comorbidity rate in patients with bipolar disorder was 58.4%(94/161) and among which the comorbidity rates of anxiety disorder were 46.6%(75/161), personality disorder 22.3% (36/161),substance dependence 9.3%(15/161), trance and possession disorder 8.7%(14/161), somatoform disorders 6.8% (11/161), acute stress reaction 3.7%(6/161), obsessive-compulsive disorder 3.1%(5/161), customary and impulsive disorders 2.5% (4/161), neurosism 2.5%(4/161), attention deficit hyperactivity disorder 1.2%(2/161), depersonalization 0.6%(1/161) and anorexia nervosa 0.6%(1/161).The comorbidity rate of bipolar disorder with one mental disorder was 25.5%(25/161),and one with two mental disorders was 15.5%(25/161),comorbidity rate of bipolar disorder with three or more wasl 7.4%(28/161).2.In the comparisons of the comorbidity group and non-comorbidity group, no significant differences were found in age,education level, marital status (P>0.05).The female proportion in the comorbidity group (74.5%) was evidently higher than that of the non comorbidity group (52.2%) (X=8.521,P<0.01) and the poorer professional state was found in the comorbidity group than in the non comorbidity group (X2=11.225, P<0.05)3.In comparison with the two clinical data, no significant differences were found in terms of attack type, personality, onset age, onset form, course of the disease family history, atypical symptoms, somatic disease, seasonal characteristics (P>0.05); and the suicidal behavior in comorbidity group was more than that in non comorbidity group (37.2% vs 19.4%,Z2=5.944, P<0.05); The higher rate of psychotic symptoms in the comorbidity group was found than in the non comorbid group (52.1% vs 34.3%,X2=5.013,P< 0.05).4.The comparison of Clinical Global Impression (CGI) between the two groups:significant differences were found in the severity between the two groups at the basemen, and at the end of 3rd month or 6th month in follow-up (P<0.01),and the lower proportion of patients with better effects in the comorbiedity group was found than that in non comorbidity group (P<0.01)5. The comparison of the social function defect scale (SDSS) be tween two groups:the scores of the SDSS at the end of the 3(T=9.08 0,T=10.203,P<0.01)or 6 months(T=2.324,T=3.259,P<0.05)were lowe r than the scores at the basement in the two groups。The scores of th e SDSS in the comorbidity group were higher than non-comorbidity group at the basement and at the end of the 3rd month or 6th month (P<0.01)Conclusions:1.Bipolar disorder and other mental disorders coexisted all the while, among which anxiety disorders and personality disorders were common.2.Women were more common and there manifestation were more complicated than men in patients with bipolar disorder.3.Patients with bipolar disorder have more psychotic symptoms and suicidal behavior, and more severe clinical manifestations.4.The comorbid patients with bipolar disorder should be paid more attention and get intensive treatment for there social function impairment was much more severer and clinical effects was more much worsen.