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Abstract：
Psychotic symptoms are prevalent in patients with bipolar disorder (BD). However, nearly all previous studies on differences in sociodemographic and clinical factors between patients with (BD P +) and without (BD P-) psychotic symptoms were conducted in Western populations, and limited information is known in China.
A total of 555 patients with BD from seven centers across China were recruited. A standardized procedure was used to collect patients\' sociodemographic and clinical characteristics. The patients were divided into BD P + or BD P- groups based on the presence of lifetime psychotic symptoms. Mann-Whitney U test or chi-square test was used to analyze differences in sociodemographic and clinical factors between patients with BD P + and BD P-. Multiple logistic regression analysis was conducted to explore factors that were independently correlated with psychotic symptoms in BD. All the above analyses were re-conducted after the patients were divided into BD I and BD II group according to their types of diagnosis.
A total of 35 patients refused to participate, and the remaining 520 patients were included in the analyses. Compared with patients with BD P-, those with BD P + were more likely to be diagnosed with BD I and mania/hypomania/mixed polarity in the first mood episode. Moreover, they were more likely to be misdiagnosed as schizophrenia than major depressive disorder, were hospitalized more often, used antidepressants less frequently, and used more antipsychotics and mood stabilizers. Multivariate analyses revealed that diagnosis of BD I, more frequent misdiagnosis as schizophrenia and other mental disorders, less frequent misdiagnosis as major depressive disorder, more frequent lifetime suicidal behavior, more frequent hospitalizations, less frequent use of antidepressants, more frequent use of antipsychotics and mood stabilizers were independently correlated with psychotic symptoms in BD. After dividing the patients into BD I and BD II groups, we observed notable differences in sociodemographic and clinical factors, as well as clinicodemographic correlates of psychotic features between the two groups.
Differences in clinical factors between patients with BD P + and BD P- showed cross-cultural consistency, but results on the clinicodemographic correlates of psychotic features were not. Notable differences between patients with BD I and BD II were found. Future work exploring the psychotic features of BD needs to take types of diagnosis and cultural differences into consideration.
This study was first registered on the website of the ClinicalTrials.gov ( https://clinicaltrials.gov/ ) on 18/01/2013. Its registration number is NCT01770704.
A total of 555 patients with BD from seven centers across China were recruited. A standardized procedure was used to collect patients\' sociodemographic and clinical characteristics. The patients were divided into BD P + or BD P- groups based on the presence of lifetime psychotic symptoms. Mann-Whitney U test or chi-square test was used to analyze differences in sociodemographic and clinical factors between patients with BD P + and BD P-. Multiple logistic regression analysis was conducted to explore factors that were independently correlated with psychotic symptoms in BD. All the above analyses were re-conducted after the patients were divided into BD I and BD II group according to their types of diagnosis.
A total of 35 patients refused to participate, and the remaining 520 patients were included in the analyses. Compared with patients with BD P-, those with BD P + were more likely to be diagnosed with BD I and mania/hypomania/mixed polarity in the first mood episode. Moreover, they were more likely to be misdiagnosed as schizophrenia than major depressive disorder, were hospitalized more often, used antidepressants less frequently, and used more antipsychotics and mood stabilizers. Multivariate analyses revealed that diagnosis of BD I, more frequent misdiagnosis as schizophrenia and other mental disorders, less frequent misdiagnosis as major depressive disorder, more frequent lifetime suicidal behavior, more frequent hospitalizations, less frequent use of antidepressants, more frequent use of antipsychotics and mood stabilizers were independently correlated with psychotic symptoms in BD. After dividing the patients into BD I and BD II groups, we observed notable differences in sociodemographic and clinical factors, as well as clinicodemographic correlates of psychotic features between the two groups.
Differences in clinical factors between patients with BD P + and BD P- showed cross-cultural consistency, but results on the clinicodemographic correlates of psychotic features were not. Notable differences between patients with BD I and BD II were found. Future work exploring the psychotic features of BD needs to take types of diagnosis and cultural differences into consideration.
This study was first registered on the website of the ClinicalTrials.gov ( https://clinicaltrials.gov/ ) on 18/01/2013. Its registration number is NCT01770704.
摘要：
背景：双相情感障碍（BD）患者普遍存在精神病症状。然而,在西方人群中进行了几乎所有关于有（BDP）和无（BDP-）精神病症状的患者之间的社会人口统计学和临床因素差异的研究，在中国已知的信息有限。
方法：招募来自中国7个中心的555例BD患者。采用标准化程序收集患者的社会人口统计学和临床特征。根据终生精神病症状的存在，将患者分为BDP或BDP-组。采用Mann-WhitneyU检验或卡方检验分析BD+和BD-患者在社会人口统计学和临床因素方面的差异。采用多因素logistic回归分析探讨与BD患者精神病性症状独立相关的因素。根据患者的诊断类型分为BDI组和BDII组后，再次进行上述分析。
结果：共有35名患者拒绝参加，其余520例患者纳入分析.与BD-患者相比，患有BDP+的患者在第一次情绪发作时更有可能被诊断为BDI和躁狂/轻躁狂/混合极性。此外，他们更容易被误诊为精神分裂症，而不是重度抑郁症，住院的频率更高，使用抗抑郁药的频率较低，并使用了更多的抗精神病药和情绪稳定剂。多变量分析显示BDI的诊断，更常见的误诊为精神分裂症和其他精神障碍，很少被误诊为重度抑郁症，更频繁的终生自杀行为，更频繁的住院，抗抑郁药的使用频率较低，更频繁使用抗精神病药和心境稳定剂与BD患者的精神病症状独立相关.将患者分为BDI组和BDII组，我们观察到社会人口统计学和临床因素的显着差异，以及两组之间精神病特征的临床人口学相关性。
结论：BD+和BD-患者的临床因素差异显示出跨文化一致性，但是精神病特征的临床人口学相关性的结果没有。发现BDI和BDII患者之间存在明显差异。探索BD精神病特征的未来工作需要考虑诊断类型和文化差异。
背景：这项研究于2013年1月18日首次在ClinicalTrials.gov（https://clinicaltrials.gov/）的网站上注册。它的注册号是NCT01770704。
方法：招募来自中国7个中心的555例BD患者。采用标准化程序收集患者的社会人口统计学和临床特征。根据终生精神病症状的存在，将患者分为BDP或BDP-组。采用Mann-WhitneyU检验或卡方检验分析BD+和BD-患者在社会人口统计学和临床因素方面的差异。采用多因素logistic回归分析探讨与BD患者精神病性症状独立相关的因素。根据患者的诊断类型分为BDI组和BDII组后，再次进行上述分析。
结果：共有35名患者拒绝参加，其余520例患者纳入分析.与BD-患者相比，患有BDP+的患者在第一次情绪发作时更有可能被诊断为BDI和躁狂/轻躁狂/混合极性。此外，他们更容易被误诊为精神分裂症，而不是重度抑郁症，住院的频率更高，使用抗抑郁药的频率较低，并使用了更多的抗精神病药和情绪稳定剂。多变量分析显示BDI的诊断，更常见的误诊为精神分裂症和其他精神障碍，很少被误诊为重度抑郁症，更频繁的终生自杀行为，更频繁的住院，抗抑郁药的使用频率较低，更频繁使用抗精神病药和心境稳定剂与BD患者的精神病症状独立相关.将患者分为BDI组和BDII组，我们观察到社会人口统计学和临床因素的显着差异，以及两组之间精神病特征的临床人口学相关性。
结论：BD+和BD-患者的临床因素差异显示出跨文化一致性，但是精神病特征的临床人口学相关性的结果没有。发现BDI和BDII患者之间存在明显差异。探索BD精神病特征的未来工作需要考虑诊断类型和文化差异。
背景：这项研究于2013年1月18日首次在ClinicalTrials.gov（https://clinicaltrials.gov/）的网站上注册。它的注册号是NCT01770704。
