首发和复发双相情感障碍患者的生活质量与经济学比较研究

摘要

Objective To compare life quality and health costs in ifrst-episode and recurrent outpatients with bipoiar disorder, thus providing evidence for early intervention. Methods 50 ifrst-episode and 50 recurrent outpatients with bipoiar disorder were recruited and life quality, direct and indirect health related costs were evaluated at the 3rd, 6th, 9th and 12th month. The clinical status and life quality of patients were assessed using Bech-Rafaelsdn Mania Rating Scale(BRMS-1),Hamilton depression scale-17 items (HAMD-17) and the Short-form-36 than health survey(SF-36). Result ①First-episode patients had better physical function and less physical pain in SF-36 than recurrent ones (P<0.05),while no difference were found for other SF-36 factors(P>0.05).②Total costs, indirect health-related costs, and proportion of indirect costs but not direct costs were higher in the recurrent group than in the ifrst-episode group(P<0.01).Costs of effectiveness ratios were much higher in the recurrent group than that in the ifrst-episode group in terms of costs of unit decrease in HAMD-17 or unit increase in SF-36. Conclusions Patients with recurrent bipoiar disorder intend to have more severe impairment of quality of life, less productivity and higher health costs.%目的：通过比较首发和复发双相情感障碍患者生活质量和治疗成本，为早期干预提供依据。方法对50例首发和50例复发双相情感障碍患者在入组后第3、6、9、12个月进行生活质量、疾病治疗的直接成本及间接成本的随访。以贝克-拉范森躁狂量表（BRMS-11）汉密尔顿抑郁量表17项（HAMD-17）和健康状况调查问卷（SF-36）分别评定患者疗效，随访12个月进行两组的生活质量与经济成本比较。结果①首发组SF-36躯体功能和躯体疼痛情况好于复发组（P＜0.05），其他因子两组无明显差异（P＞0.05）；②复发组的总成本绝对值、间接成本绝对值及间接成本所占比例均高于首发组（P＜0.01）。结论双相情感障碍的复发患者与首发患者相比，生活质量和治疗花费成本更多。