Background

: Studies exploring disability in bipolar disorder (BD) have primarily assessed clinical samples of full-threshold BD-I and BD-II alongside so-called objective criteria such as unemployment or receipt of government disability payments. This study extends research on disability by examining externally determined and self-identified disability in a community sample and by including subthreshold BD (BDS).

Methods

: Data were extracted from the USA Collaborative Psychiatric Epidemiology Surveys about individuals who met recognized criteria for BD-I, BD-II and BDS who had completed self-ratings of physical and mental disability, comorbidities, and health risk factors (e.g., obesity). Rates of disability were estimated, and logistic regression analyses were used to determine demographic and clinical variables associated with externally determined and self-identified of disability.

Results

: Of 408 individuals who met eligibility criteria (BD-I = 100; BD-II=104; BDS=204), 35% met criteria for externally determined disability, about 40% self-reported mental disability and about 23% self-reported physical disability. The odds were three-fold (Odds Ratio (OR): 3.05; 95% Confidence Intervals (CI): 1.69, 5.53) that someone with self-identified physical disability would meet criteria for externally determined disability, but associations with mental disability were non-significant (OR: 1.06; 95% CI: 0.63, 1.80). Regression analyses demonstrated that mental disability was associated with being a current or past smoker and physical disability was associated with BD-I.

Limitations

: the adequacy of the assessments of disability and definition of BDS can be questioned.

Conclusions

: Future clinical and community studies need to consider both externally determined and self-identified disability across the entire Bd spectrum.

中文翻译：

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跨双相情感障碍谱的外部确定和自我识别的精神和身体残疾的流行病学研究

背景

：探索双相情感障碍 (BD) 残疾的研究主要评估了全阈值 BD-I 和 BD-II 的临床样本以及所谓的客观标准，例如失业或收到政府残疾补助金。本研究通过在社区样本中检查外部确定和自我识别的残疾并包括亚阈值 BD (BDS)，扩展了对残疾的研究。

方法

：数据来自美国合作精神病学流行病学调查，关于符合 BD-I、BD-II 和 BDS 公认标准的个人，这些人已完成身体和精神残疾、合并症和健康风险因素（例如，肥胖）的自我评估. 估计残疾率，并使用逻辑回归分析来确定与外部确定和自我确定的残疾相关的人口统计学和临床​​变量。

结果

：在符合资格标准的 408 人中（ BD- I = 100；BD-II=104；BDS=204），35% 符合外部确定的残疾标准，约 40% 自我报告精神残疾，约 23% 自我报告身体残疾。自我认定的身体残疾的人符合外部确定的残疾标准的可能性是三倍（比值比 (OR)：3.05；95% 置信区间 (CI)：1.69, 5.53），但与精神残疾无关-显着（OR：1.06；95% CI：0.63, 1.80）。回归分析表明精神残疾与目前或过去吸烟者有关，身体残疾与 BD-I 相关。

限制

：残疾评估和 BDS 定义的充分性可能受到质疑。

结论

：未来的临床和社区研究需要考虑整个 Bd 谱中的外部确定和自我确定的残疾。