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Abstract：
BACKGROUND: Rapid cycling bipolar disorder (RCBD), characterized by four or more episodes per year, is a complex subtype of bipolar disorder (BD) with poorly understood characteristics.
METHODS: This multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal-Wallis H tests, Chi-square or Fisher\'s exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD.
RESULTS: Among the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472).
CONCLUSIONS: This study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD. Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013.
METHODS: This multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal-Wallis H tests, Chi-square or Fisher\'s exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD.
RESULTS: Among the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472).
CONCLUSIONS: This study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD. Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013.
摘要：
背景：快速循环双相情感障碍（RCBD），以每年四次或更多次发作为特征，是双相情感障碍（BD）的复杂亚型，对其特征了解甚少。
方法：这个多中心，观察,纵向队列研究纳入了2013年1月至2014年1月中国7家精神病院的520例BD患者.根据前一年情绪发作的频率，参与者分为RCBD和非RCBD（NRCBD）组。数据收集采用标准化形式，辅以病历审查，关注社会人口统计学，临床,和治疗特点。统计分析涉及独立样本t检验，Kruskal-WallisH测试,卡方或费舍尔精确检验，使用Bonferroni校正来解释多重比较，和多变量逻辑回归来确定与RCBD相关的特征。
结果：在BD队列中，9.4％被确定为当前的RCBD。与NRCBD相比，RCBD患者从第一次精神病咨询到BD诊断的持续时间较短，缩短了他们最长的恢复时间，由于BD导致的终生住院史比例较低，并且在过去12个月内较少使用电惊厥治疗（ECT）。此外,他们在情绪障碍问卷(MDQ)和简短的16项抑郁症状自我报告快速量表(QIDS-SR16)上的基线得分较高.然而,在应用Bonferroni校正后，这些差异没有统计学意义.多变量逻辑回归分析确定了与RCBD独立相关的三个因素：从首次精神病咨询到BD诊断的时间（比值比[OR]=0.512，P=0.0416），因BD引起的终生住院史(OR=0.516,P=0.0476),过去12个月内接受ECT治疗（OR=0.293，P=0.0472）。
结论：这项研究表明，从第一次精神病咨询到BD诊断的持续时间，由于BD导致的终生住院史，过去一年的ECT治疗与RCBD相关。认识到这些因素可能有助于增强RCBD的早期识别和临床结果。试验登记号登记处ClinicalTrials.govNCT01770704。注册日期：2013年1月18日首次发布。
方法：这个多中心，观察,纵向队列研究纳入了2013年1月至2014年1月中国7家精神病院的520例BD患者.根据前一年情绪发作的频率，参与者分为RCBD和非RCBD（NRCBD）组。数据收集采用标准化形式，辅以病历审查，关注社会人口统计学，临床,和治疗特点。统计分析涉及独立样本t检验，Kruskal-WallisH测试,卡方或费舍尔精确检验，使用Bonferroni校正来解释多重比较，和多变量逻辑回归来确定与RCBD相关的特征。
结果：在BD队列中，9.4％被确定为当前的RCBD。与NRCBD相比，RCBD患者从第一次精神病咨询到BD诊断的持续时间较短，缩短了他们最长的恢复时间，由于BD导致的终生住院史比例较低，并且在过去12个月内较少使用电惊厥治疗（ECT）。此外,他们在情绪障碍问卷(MDQ)和简短的16项抑郁症状自我报告快速量表(QIDS-SR16)上的基线得分较高.然而,在应用Bonferroni校正后，这些差异没有统计学意义.多变量逻辑回归分析确定了与RCBD独立相关的三个因素：从首次精神病咨询到BD诊断的时间（比值比[OR]=0.512，P=0.0416），因BD引起的终生住院史(OR=0.516,P=0.0476),过去12个月内接受ECT治疗（OR=0.293，P=0.0472）。
结论：这项研究表明，从第一次精神病咨询到BD诊断的持续时间，由于BD导致的终生住院史，过去一年的ECT治疗与RCBD相关。认识到这些因素可能有助于增强RCBD的早期识别和临床结果。试验登记号登记处ClinicalTrials.govNCT01770704。注册日期：2013年1月18日首次发布。
