psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2022-20-2-24-31psychiatry-821Research ArticleПСИХОПАТОЛОГИЯ, КЛИНИЧЕСКАЯ И БИОЛОГИЧЕСКАЯ ПСИХИАТРИЯPSYCHOPATHOLOGY, CLINICAL AND BIOLOGICAL PSYCHIATRYВлияние несвоевременной диагностики биполярного аффективного расстройства на основные клинико- динамические характеристики заболевания, суицидальное поведение и уровень социальной адаптации пациентовLate Diagnostics of Bipolar Disorder: Impact on Main Characteristics of Disease, Suicidal Behaviour and Social Adaptation Level of Patientshttps://orcid.org/0000-0002-0939-0856ВасильеваС. Н.VasilievaS. N.

Светлана Николаевна Васильева, кандидат медицинских наук

Томск

Svetlana N. Vasilieva, Cand. of Sci. (Med)

Tomsk

vasilievasn@yandex.ruhttps://orcid.org/0000-0003-2148-297XСимуткинГ. Г.SimutkinG. G.

Герман Геннадьевич Симуткин, доктор медицинских наук

Томск

German G. Simutkin, Dr. of Sci. (Med.)

Tomsk

ggsimutkin@gmail.comhttps://orcid.org/0000-0003-2148-297XСчастныйЕ. Д.SchastnyyE. D.

Евгений Дмитриевич Счастный, профессор, доктор медицинских наук, заведующий отделением аффективных состояний

Томск

Evgeny D. Schastnyy, Professor, Dr. of Sci. (Med.), Head of the Affective States Department

Tomsk

evgeny.schastnyy@gmail.comhttps://orcid.org/0000-0001-6117-6454ЛебедеваЕ. В.LebedevaE. V.

Елена Владимировна Лебедева, кандидат медицинских наук

Томск

Elena V. Lebedeva, Cand. of Sci. (Med.)

Tomsk

evl26021971@gmail.comhttps://orcid.org/0000-0002-1052-855XБоханН. А.BokhanN. А.

Николай Александрович Бохан, академик РАН, профессор, доктор медицинских наук, директор; заведующий кафедрой психиатрии, психотерапии, наркологии с курсом медицинской психологии

Томск

Nikolay A. Bokhan, Academician of RAS, Professor, Dr. of Sci. (Med.), Director; Head of the Department of Psychiatry, Addiction Psychiatry, Psychotherapy with the Course of Medical the Psychology

Tomsk

mental@tnimc.ruФГБНУ «Научно-исследовательский институт психического здоровья», Томский национальный исследовательский медицинский центр Российской академии наукРоссияFSBSI “Tomsk National Research Medical Center, Russian Academy of Sciences”, Mental Health Research InstituteRussian FederationФГБНУ «Научно-исследовательский институт психического здоровья», Томский национальный исследовательский медицинский центр Российской академии наук; ФГБОУ ВО «Сибирский государственный медицинский университет» МЗ РФРоссияFSBSI “Tomsk National Research Medical Center, Russian Academy of Sciences”, Mental Health Research Institute; Siberian State Medical UniversityRussian Federation2022040720222022431Copyright © Васильева С.Н., Симуткин Г.Г., Счастный Е.Д., Лебедева Е.В., Бохан Н.А., 20222022Васильева С.Н., Симуткин Г.Г., Счастный Е.Д., Лебедева Е.В., Бохан Н.А.Vasilieva S.N., Simutkin G.G., Schastnyy E.D., Lebedeva E.V., Bokhan N.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/821

Цель исследования: изучение влияния несвоевременной диагностики биполярного аффективного расстройства (БАР) на основные клинико-динамические показатели заболевания, суицидальное поведение, уровень субъективной оценки социальной адаптации, а также трудовой статус пациентов. Пациенты и методы исследования: в психиатрическом стационаре обследован 121 пациент (83 женщины, 68,6%, и 38 мужчин, 31,4%) с верифицированным (по критериям МКБ-10) диагнозом БАР. Проведена сравнительная оценка показателей, которые могли отражать причины и последствия ошибочной диагностики БАР. В 1-ю группу вошли пациенты (n = 46), у которых диагноз БАР был установлен при первичном обращении к психиатру, во 2-ю группу — пациенты (n = 75), у которых диагностика БАР была отсрочена. Использовались клинико-психопатологический, клинико-анамнестический, психометрический, статистический методы. Результаты: выявлен низкий уровень верификации БАР при первом обращении пациентов к психиатру — 38%. Показано, что тревожные расстройства, коморбидные БАР, усложняют его диагностику. У пациентов с поздней диагностикой БАР в анамнезе чаще выявлялись суицидальные попытки, а суммарный балл опросника суицидального поведения (The Suicidal Behaviors Questionnaire-Revised, SBQ-R) оказался выше по сравнению с пациентами, которым диагноз БАР был выставлен при первом обращении к психиатру (p < 0,05). В группе с запоздалой верификацией БАР было выявлено больше пациентов, не работающих вследствие аффективного расстройства, по сравнению с группой, где БАР диагностировали при первичном обращении к психиатру — 22,7% (n = 17) и 8,7% (n = 4) соответственно (p < 0,05), а также более низкий уровень субъективной оценки своей социальной адаптации (p < 0,05). Выводы: позднее распознавание БАР увеличивает суицидальный риск и негативно отражается на трудоспособности и уровне социальной адаптации пациентов.

The aim was to study the impact of late diagnostics of bipolar disorder (BD) on the main clinical and dynamic indicators, suicidal behavior, the subjective evaluation of social adaptation level, and employment status of patients. Patients and methods: 121 in-patients (38 males, 31.4% and 83 females, 68.6%) with a veried diagnosis of bipolar disorder (according to the ICD-10 

criteria) were examined. A comparative evaluation of indicators that could reect the causes and consequences of delayed diagnostics of bipolar disorder was performed. The rst group (n = 46) included patients with BD veried during the initial visit to a psychiatrist, and the second group (n = 75) made up patients with late diagnosis of BD. Clinical, psychopathological, follow- up, psychometric, statistical methods were used. Results: delay in the diagnosis of BD was 38%. Comorbid anxiety disorders were the most signicant confounding factor of late diagnostics of BD. Suicidal attempt incidence and the total SBQ-R (The Suicidal Behaviors Questionnaire-Revised) score were higher in cases of late diagnosis of BD (p < 0.05). In the group with late diagnosis of BD, 17 patients (22.7%) were unemployed due to affective disorder compared to 4 patients (8.7%) with BD diagnosed at the rst visit to psychiatrist (p < 0.05), and a lower level of subjective evaluation of their social adaptation was revealed (p < 0.05). Conclusions: late diagnostics of bipolar disorder increases suicide risk and negative impact on the employment status and reduces social adaptation of patients.

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The authors declare that there are no conflicts of interest present.