双极性指数对双相障碍的识别效能

目的:探讨双极性指数(bipolarity index,BPX)对双相障碍(BD)的识别效能。方法:对经简明国际神经精神访谈(MINI)、符合美国精神障碍诊断与统计手册第4版(DSM-IV)BD及复发性抑郁症(RMDD)诊断标准的住院患者各60例进行BPX评估表评估,BPX总分包含躁狂发作特征、发病年龄、病程/相关特征、治疗反应及家族史5个维度。结果:BD组BPX为35~95分,平均(67.4±13.0)分;RMDD组为7~27分,平均(15.3±4.1)分;BD组BPX评分显著高于RMDD组(P0.05)。以BPX 44分为分界值,筛查BD的灵敏度为93.7%,特异度为100%,漏诊率为6.3%,阴性预测值93.7%;以BPX38.5分为界值分,筛查BD的灵敏度为98.3%,特异度为100%,漏诊率为1.7%,阴性预测值98.3%。RMDD组没有1例≥38.5分。BD组和RMDD组BPX评分均与首发年龄、治疗反应呈正相关(P均0.01);BD组BPX评分亦与文化程度及家族史呈正相关(P均0.05)。结论:应用BPX筛检BD具有较高的灵敏度和特异度。有家族史、发作频繁、首次发作年龄小的患者BPX评分高。

Recognition performance of bipolar index on bipolar disorder

Objective：To explore the recognition performance of bipolarity index （BPX） on bipolar disorder （BD）. Method：Sixty BD and 60 recurrent major depressive disorder （RMDD） inpatients were enrolled in the study who met the American diagnostic and statistical manual of mental disorders 4th edition（DSM-IV） diagnostic criteria for BD or RMDD.All patients were interviewed by mini-international neuropsychiatric interview （MINI） and evaluated by BPX.The total BPX score was including 5 domains such as characteristics of manic episode,onset age,illness course/related features,treatment response and family history.Results：The BPX scores in BD group was 35-95,average （67.4±13.0）; in RMDD group was 7-27,average （15.3±4.1）.The BPX scores in BD group was significantly higher than RMDD group （P＜0.05）. For screening BD,when the cut-off value of BPX as 44 scores the sensitivity,specificity,omission diagnose rate and negative predictive value was 93.7%,100%,6.3% and 93.7%,respectively; when the cut-off value of BPX as 38.5 scores,the sensitivity,specificity,omission diagnose rate and negative predictive value of BD was 98.3%,100%,1.7% and 98.3%,respectively.No one case in RMDD group was BPX score≥38.5.The BPX scores in BD and RMDD groups were positively correlated with age of first episode and treatment response （all P＜0.01）;and also positively correlated with education level and family history in BD group （all P＜0.05）.Conclusion：There is a higher sensitivity and specificity in screening BD by BPX.The patients with positive family history,more episodes and first episode with younger age tend to getting higher BPX score.