CAJ | 학술논문

目的回顾性分析儿童双相障碍住院患者诊断稳定性及相关因素.方法对北京安定医院2007年7月至2012年6月出院时年龄＜18岁、入院时或出院时曾经诊断双相障碍患者的诊断稳定性及相关因素进行分析,采用“向前条件”方法进行二分类多因素logistic回归分析.结果 5年间曾诊断为双相障碍患者共342例,总住院次数400次,共有800项诊断(包括入院诊断和出院诊断)；342例患者双相障碍诊断的总体一致率为66.7％(228例)；Logistic回归分析结果显示,双相障碍诊断稳定性与住院次数[OR=4.912,95％可信区间(CI)2.520～9.577,P=0.000]、幻觉妄想症状(OR=2.841,95％CI1.670～4.836,P=0.000)、躁狂状态(OR=0.365,95％CI0.215～0.619,P=0.000)显著相关.结论儿童双相障碍症状不典型,伴有精神病性症状较常见,诊断稳定性主要受住院次数、幻觉妄想症状及躁狂状态影响.
목적 회고성분석인동쌍상장애주원환자진단은정성급상관인소.방법 대북경안정의원2007년7월지2012년6월출원시년령＜18세、입원시혹출원시증경진단쌍상장애환자적진단은정성급상관인소진행분석,채용“향전조건”방법진행이분류다인소logistic회귀분석.결과 5년간증진단위쌍상장애환자공342례,총주원차수400차,공유800항진단(포괄입원진단화출원진단)；342례환자쌍상장애진단적총체일치솔위66.7％(228례)；Logistic회귀분석결과현시,쌍상장애진단은정성여주원차수[OR=4.912,95％가신구간(CI)2.520～9.577,P=0.000]、환각망상증상(OR=2.841,95％CI1.670～4.836,P=0.000)、조광상태(OR=0.365,95％CI0.215～0.619,P=0.000)현저상관.결론 인동쌍상장애증상불전형,반유정신병성증상교상견,진단은정성주요수주원차수、환각망상증상급조광상태영향.
Objective To retrospectively analyze diagnostic consistency in pediatric patients with bipolar disorders.Methods Data was collected from the information of pediatric inpatients (＜ 18 years)discharged from Beijing An-ding hospital affiliate of Capital Medical University during July 1,2007 and June 30,2012,who were diagnosed as bipolar disorders at admission and (or) discharge.Multivariate binary logistic regression was employed to analyze influencing factors of the diagnostic stability.Results 342 cases were selected during the five years,the total frequency of hospitalization was 400 times with 800 main hospital diagnoses (both at admission and at discharge),66.7％ cases were all diagnosed as bipolar disorders at every admission and discharge,and were considered as diagnostic stable ones.Statistically significant variables remaining in the final logistic regression model suggested that more frequent hospitalization (OR =4.912,95％ CI 2.520-9.577,P =0.000) and the presence of hallucinations or delusions (OR =2.841,95 ％ CI 1.670-4.836,P =0.000) and the absence of mania (OR =0.365,95 ％CI 0.215-0.619,P =0.000) in cover page of medical records might be higher possibility of diagnostic inconsistency.Conclusion The presentation of childhood bipolar disorder is often atypical with higher possibility of diagnostic inconsistency.