广东省双相情感障碍患者危险行为的流行病学特征及其影响因素

doi:10.13481/j.1671-587X.20210630

Abstract

Abstract: Objective

To explore the mental life status and risk behavior levels of the patients with bipolar disorder（BPD） in Guangdong Province and clarify the influencing factors of risk behavior levels， and to provide the basis for the development of related management and treatment policies.

Methods

By using the multi-stage sampling method， 870 BPD patients who were hospitalized or managed in the mental health institutions （specialized mental health institutions and community health service centers） in 11 prefecture-level cities in Guangdong Province from December 2018 to February 2019 were investigated by questionnaire and physical examination.The patients were divided into low risk group （grade 0－2，n=798） and high risk group （grade 3－5，n=72） according to the risk behavior assessment grade. The general demographic characteristics， clinical characteristics，and symptoms of the BPD patients in Guangdong Province were statistically analyzed. The influencing factors of risk behaviors of the BPD patients were analyzed by multivariate Logistic regression.

Results

The avarage age of the BPD patients in low-risk group was higher than that in high-risk group （P<0.05）. The composition ratios of male BPD patients in both two groups were higher， and the composition ratio of male BPD patients in high risk group was higher than that in low risk group （P<0.05）.The composition ratio of married/cohabitant BPD patients in low risk group was higher than that in high risk group （P<0.05），while the composition ratio of single and unmarried patients in high risk group was higher than that in low risk group （P<0.05）. The percentages of clinical symptoms such as hallucination， suspicion， moodiness， weird behavior， excitement and loquacity， wounding and destroying objects， going outside without a reason of the BPD patients in high risk group were higher than those in low risk group （P<0.05）.The composition ratios of male patients ［OR （95%CI）=1.925（1.093－3.390）］，inpatients ［OR （95%CI）=6.145（2.775－13.607）］， lock-in ［OR （95%CI） =3.178（1.523－6.629）］， and drug noncompliance ［OR （95%CI） =4.390（2.500－7.708）］ of the BPD patients in high risk group were higher than those in low risk group （P<0.05）.

Conclusion

Age， gender， source of patients， and medication compliance are the important influencing factors for the occurrence of risk behaviors of the BPD patients.Low age， female patients， community living patients， and regular medication play positive roles in the dowregulation of occurrence of risk behaviors of the BPD patients. The comprehensive and effective management models should be developed for the BPD patients to improve their quality of life.

Key words: Guangdong Province, bipolar disorder, risk behavior evaluation, influencing factors, Logistic regression

CLC Number:

R749.3

Dong CHEN,Na ZHOU,Xin ZHANG,Xiaoyu TAO,Wenyan TAN,Haicheng LIN,Shibin WANG,Saisai ZHAO,Wenhui GAO,Lina JIN,Yaqin YU. Epidemiological characteristics and influencing factors of risk behaviors of patients with bipolar disorder in Guangdong Province[J].Journal of Jilin University(Medicine Edition), 2021, 47(6): 1562-1569.

Figures/Tables 4

Tab. 1

Tab.2

Tab.3

Tab. 4

References 25

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Variable	Total (Constituent ratio)	Low risk （n=798）	High risk （n=72）	χ2/t	P
Age(year)		41.05±0.51	33.89±1.38	4.876	<0.01
Gender				6.264	0.008
Male	482(55.4)	432(54.1)	50(69.4)
Female	388(44.6)	366(45.9)	22(30.6)
Education level				1.796	0.616
Primary school or illiteracy	187(21.5)	172(21.6)	15(20.8)
Middle school	286(32.9)	258(32.3)	28(38.9)
High school or technical secondary school	216(24.8)	202(25.3)	14(19.4)
University or college	181(20.8)	166(20.8)	15(20.9)
Marital status				8.375	0.015
Never married	369(42.4)	328(41.1)	41(56.9)
Married	405(46.6)	383(48.0)	22(30.6)
Widowed / divorced / other	96(11.0)	87(10.9)	9(12.5)
Occupation				1.871	0.600
Payroll	101(11.6)	92(11.5)	9(12.5)
Laid-off or unemployed	377(43.3)	343(43.0)	34(47.2)
Farmer	177(20.3)	161(20.2)	16(22.2)
Other	215(24.8)	202(25.3)	13(18.1)
Average annual family				0.1903	0.909
<1	335(38.5)	309(38.7)	26(36.1)
1－4	337(38.7)	308(38.6)	29(40.3)
>4	198(22.8)	181(22.7)	17(23.6)
Smok				11.282	0.004
Never smoking	611(70.2)	571(71.6)	40(55.6)
Smoking before	76(8.7)	63(7.8)	13(18.1)
Smoking now	183(21.1)	164(20.6)	19(26.3)
Drinking				15.800	<0.01
Never drinking	714(82.1)	667(83.6)	47(65.3)
Drinking before	97(11.1)	80(10.0)	17(23.6)
Drinking now	59(6.8)	51(6.4)	8(11.1)
Regular exercise in past six months				8.306	0.016
Never/hardly	370(42.5)	340(42.6)	30(41.7)
Occasionally/often	357(41.1)	319(40.0)	38(52.8)
Every day/almost every day	143(16.4)	139(17.4)	4(5.5)
Sleep time (t/h)				1.308	0.250
<7	206(23.7)	185(23.2)	21(29.2)
≥7	664(76.3)	613(76.8)	51(70.8)
BMI(kg·m^－2)	870	23.80±0.15	23.09±0.47	85.155	<0.01

Variable	Total (constituent ratio)	Low risk （n=798）		χ2/t	P
Prevalence				1.194	0.277
First round	48(5.5)	42(5.3)	6(8.3)
Chronic	822(94.5)	756(94.7)	66(91.7)
Source of patients				68.248	<0.01
Patients in hospital	372(42.8)	308(38.6)	64(88.9)
Patients in community	498(57.2)	490(61.4)	8(11.1)
Course of disease（year）				0.928	0.629
<10	447(51.4)	407(51.0)	40(55.6)
10－20	255(29.3)	234(29.3)	21(29.1)
>20	168(19.3)	157(19.7)	11(15.3)
Lock				37.942	<0.01
No lock	796(91.5)	744(93.2)	52(72.2)
Lock released	16(1.8)	11(1.4)	5(6.9)
Close and lock	58(6.7)	43(5.4)	15(20.9)
Medication compliance				64.379	<0.01
Compliance	727(83.6)	691(86.6)	36(50.0)
Noncompliance	143(16.4)	107(13.4)	36(50.0)
Hallucination				11.578	0.001
Yes	116(13.3)	97(12.2)	19(26.4)
No	754(86.7)	701(87.8)	53(73.6)
Communication difficulties				0.756	0.385
Yes	73(8.4)	65(8.1)	8(11.1)
No	797(91.6)	733(91.9)	64(88.9)
Suspicion				11.413	0.002
Yes	134(15.4)	113(14.2)	21(29.2)
No	736(84.6)	685(85.8)	51(70.8)
Moody				7.860	0.008
Yes	169(19.4)	146(18.3)	23(31.9)
No	701(80.6)	652(81.7)	49(68.1)
Bizarre				9.498	0.005
Yes	115(13.2)	97(12.2)	18(25.0)
No	755(86.8)	701(87.8)	54(75.0)
Excitement and loquacity				26.241	<0.01
Yes	245(28.2)	206(25.8)	39(54.2)
No	625(71.8)	592(74.2)	33(45.8)
Injury and destruction				33.511	<0.01
Yes	55(6.3)	39(4.9)	16(22.2)
No	815(93.7)	759(95.1)	56(77.8)
Pessimistic and worldweary				2.665	0.113
Yes	95(10.9)	83(10.4)	12(16.7)
No	775(89.1)	715(89.6)	60(83.3)

Going outside without a reason				5.644	0.026
Yes	45(5.2)	37(4.6)	8(11.1)
No	825(94.8)	761(95.4)	64(88.9)
Speech to themselves or no reasoning laugh				2.994	0.093
Yes	83(9.5)	72(9.0)	11(15.3)
No	787(90.5)	726(91.0)	61(84.7)
Lonely and lazy				0.703	0.402
Yes	139(16.0)	125(15.7)	14(19.4)
No	731(84.0)	673(84.3)	58(80.6)

Variable	Assignment
Dependent variable	1=Low risk，2= High risk
Gender	1=Female，2=Male
Marital status	1=Never married，2=Married，3=Widowed / divorced / other
Smoke	1=Never smokeing，2=Smoking before，3=Smoking now
Drink wine	1=Never drinking，2=Drinking before，3=Drinking now
Regular exercise in the past six months	1=Never / hardly，2=Occasionally / often，3=Every day / almost every day
Source of patients	1=Patients in community，2= Patients in hospital
Lock	1=No lock，2=Lock released，3=Close the lock
Medication compliance	1=Compliance，2=Noncompliance
Illusion	1= Yes，2=No
Suspicion	1= Yes，2=No
Moody	1= Yes，2=No
Bizarre	1= Yes，2=No
Excitement and loquacity	1= Yes，2=No
Injury and destruction	1= Yes，2=No
Going outside without a reason	1= Yes，2=No

Variable	β	SE	Wald χ²	OR	95% CI	P
Age(year)	－0.024	0.012	4.484	0.976	0.954－0.998	0.034
Gender
Female				1.000
Male	0.655	0.289	5.144	1.925	1.093－3.390	0.023
Source of patients
Patients in community				1.000
Patients in hospital	－1.816	0.406	20.043	6.145	2.775－13.607	<0.01
Lock
No lock				1.000
Lock released	1.069	0.613	3.041	2.911	0.876－9.674	0.081
Close the lock	1.156	0.375	9.495	3.178	1.523－6.629	0.002
Medication compliance
Compliance				1.000
Noncompliance	1.479	0.287	26.524	4.390	2.500－7.708	<0.01

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Epidemiological characteristics and influencing factors of risk behaviors of patients with bipolar disorder in Guangdong Province

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