Background
Methods
Subjects
Sample size and sources
Inclusion criteria
Exclusion criteria
Measures
Survey tools
Characteristic | BD (n = 48) | Atypical (n = 63) | Anxiety (n = 111) |
χ
2
| F | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean ± SD |
n
| Percentage (%) | Mean ± SD |
n
| Percentage (%) | Mean ± SD |
n
| Percentage (%) | ||||
Age (years) | 33.06 ± 14.53 | 34.33 ± 15.55 | 37.38 ± 12.15 | 0.676 | ||||||||
Sex | Male | 15 | 31.3 | 18 | 28.6 | 39 | 35.1 | 0.276 | ||||
Female | 33 | 68.8 | 45 | 71.4 | 72 | 64.9 | ||||||
Nationality | Han | 45 | 93.8 | 60 | 95.2 | 105 | 94.6 | 0.039 | ||||
Minority | 3 | 6.3 | 3 | 4.8 | 6 | 5.4 | ||||||
Birth place | SC | 42 | 87.5 | 51 | 80.9 | 105 | 94.6 | 5.728 | ||||
CQ | 3 | 6.3 | 0 | 0 | 0 | 0 | ||||||
GZ | 0 | 0 | 3 | 4.8 | 0 | 0 | ||||||
Others | 3 | 6.3 | 9 | 14.3 | 6 | 5.4 | ||||||
Residence | City | 36 | 75 | 54 | 85.7 | 90 | 81.1 | 0.680 | ||||
Village | 12 | 25 | 9 | 14.3 | 21 | 18.9 | ||||||
Education | Primary | 0 | 0 | 0 | 0 | 9 | 8.1 | 5.267 | ||||
Middle | 12 | 25 | 15 | 23.8 | 24 | 21.6 | ||||||
High | 24 | 50 | 27 | 42.9 | 33 | 29.7 | ||||||
Bachelor | 12 | 25 | 21 | 33.3 | 45 | 40.5 | ||||||
Master | 0 | 0 | 0 | 0 | 0 | 0 | ||||||
Marriage | Unmarried | 27 | 56.3 | 30 | 47.6 | 24 | 21.6 | 14.493** | ||||
Married | 12 | 25 | 27 | 42.9 | 81 | 73 | ||||||
Divorced | 6 | 12.5 | 6 | 9.5 | 6 | 5.4 | ||||||
Remarried | 0 | 0 | 0 | 0 | 0 | 0 | ||||||
Widowed | 0 | 6.3 | 0 | 0 | 0 | 0 | ||||||
Work | None | 24 | 50 | 24 | 38.1 | 30 | 27 | 3.926 | ||||
Student | 12 | 25 | 18 | 28.6 | 15 | 13.5 | ||||||
Worker | 6 | 12.5 | 0 | 0 | 12 | 10.8 | ||||||
Teacher | 3 | 6.3 | 3 | 4.8 | 9 | 8.1 | ||||||
Doctor | 0 | 0 | 0 | 0 | 3 | 2.7 | ||||||
Civil servant | 0 | 0 | 6 | 9.5 | 12 | 10.8 | ||||||
Staff | 0 | 0 | 12 | 19 | 18 | 16.2 | ||||||
Others | 3 | 6.3 | 0 | 0 | 12 | 10.8 |
Variables | BD (n = 48) | Atypical (n = 63) | Anxiety (n = 111) |
χ
2
| ||||
---|---|---|---|---|---|---|---|---|
n
| % |
n
| % |
n
| % | |||
Type of BD | Hypomania | 0 | 0 | |||||
Non psychotic mania | 12 | 25 | ||||||
Psychotic mania | 3 | 6.3 | ||||||
Mixed state | 15 | 31.3 | ||||||
Remission | 0 | 0 | ||||||
Mild depression | 12 | 25 | ||||||
Non psychotic major depression | 3 | 6.3 | ||||||
Psychotic major depression | 3 | 6.3 | ||||||
Type of anxiety | GAD | 54 | 85.7 | 75 | 67.6 | 5.607 | ||
OCD | 6 | 9.5 | 27 | 24.3 | ||||
Stress related disorders | 3 | 4.8 | 0 | 0 | ||||
Panic Disorder | 0 | 0 | 9 | 8.1 | ||||
First onset | No | 48 | 100 | 48 | 76.2 | 90 | 81.1 | 4.187 |
Yes | 0 | 0 | 15 | 23.8 | 21 | 18.9 | ||
Type of first onset | GAD | 36 | 75 | 57 | 90.5 | 78 | 70.3 | 2.090 |
OCD | 6 | 12.5 | 3 | 4.8 | 24 | 21.6 | ||
Stress related disorders | 3 | 6.3 | 3 | 4.8 | 0 | 0 | ||
Panic Disorder | 3 | 6.3 | 0 | 0 | 9 | 8.1 | ||
Family history | No | 42 | 87.5 | 51 | 81 | 99 | 89.2 | 0.796 |
Yes | 6 | 12.5 | 12 | 19 | 12 | 10.8 | ||
Drug abuse | No | 45 | 93.8 | 60 | 95.2 | 108 | 97.3 | 0.399 |
Yes | 3 | 6.3 | 3 | 4.8 | 3 | 2.7 | ||
Other disease | No | 45 | 93.8 | 51 | 81 | 87 | 78.4 | 1.867 |
Yes | 3 | 6.3 | 12 | 19 | 24 | 21.6 |
Variables | BD (n = 48) | Atypical (n = 63) | Anxiety (n = 111) | F |
---|---|---|---|---|
Mean ± SD | Mean ± SD | Mean ± SD | ||
Number of onsets | 5.50 ± 2.53a
| 3.19 ± 1.81 | 3.29 ± 1.99b
| 7.351**
|
Age of first onset (years) | 22.50 ± 10.69c
| 28.67 ± 13.76 | 30.62 ± 12.32 | 2.397 |
Months since diagnosis | 64.87 ± 73.35 | 59.14 ± 60.24 | 54.84 ± 85.92 | 0.097 |
Frequency (number/year) | 1.72 ± 2.87 | 1.15 ± 1.27 | 1.01 ± 1.54 | 0.820 |
Suicidal ideation | 2.00 ± 2.07d
| 1.76 ± 2.09e
| 0.57 ± 1.42 | 4.996**
|
Examination of endocrine axes
Examination of inflammatory cytokines
Data collection
Statistical analysis
Results
Basic conditions among the BD, atypical BD and simple anxiety groups
Demographic characteristics
Clinical features of disease among the three groups
Characteristics of symptoms between the atypical BD group and the simple anxiety group at enrolment
Variables | Atypical (n1 = 63, n2 = 6) Mean ± SD | Anxiety (n1 = 111, n2 = 27) Mean ± SD | t |
---|---|---|---|
YMRS-4 (sleep) | 0.67 ± 0.90 | 0.03 ± 0.16 | 4.569***
|
YMRS-5 (irritability) | 0.86 ± 0.95 | 0.14 ± 0.48 | 4.698***
|
YMRS-7 (thought form) | 0.05 ± 0.22 | 0 | 2.340*
|
YMRS-8 (thought content) | 0.14 ± 0.35 | 0 | 4.214***
|
YMRS-9 (aggressive behaviour) | 0.05 ± 0.22 | 0 | 2.340*
|
YMRS-10 (appearance) | 0.05 ± 0.22 | 0 | 2.340*
|
Total score of YMRS | 1.81 ± 1.94 | 0.16 ± 0.49 | 5.433***
|
HAMA-5 (cognitive function) | 1.90 ± 0.53 | 1.54 ± 0.83 | 2.646**
|
HAMA-6 (depressed mood) | 2.05 ± 1.06 | 1.46 ± 0.86 | 3.534**
|
HAMA-8 (sensory symptoms) | 0.67 ± 1.00 | 1.35 ± 1.24 | −3.200**
|
HAMA-13 (ANS symptoms) | 1.14 ± 0.65 | 1.46 ± 0.89 | −2.099*
|
HAMA-14 (performance) | 1.57 ± 0.67 | 1.97 ± 0.49 | −3.546**
|
Somatic anxiety factor | 4.14 ± 3.82 | 5.76 ± 3.46 | −2.503*
|
Total score of YBOCS | 22.50 ± 4.95 | 19.22 ± 2.95 | 2.052*
|
Comparing efficacy of treatment between the atypical BD and simple anxiety groups
Variables | Anxiety (n1 = 111, n2 = 27) | Atypical (n1 = 63, n2 = 6) |
χ
2
| ||||||
---|---|---|---|---|---|---|---|---|---|
Enrolment | 3 months later | Reduction ratea
| Enrolment | 3 months later | 6 months later | Reduction rateb
| Reduction ratec
| ||
Total HAMA score | 16.92 ± 3.26 | 5.58 ± 1.46** | 67.02 | 16.13 ± 3.98 | 14.82 ± 3.15 | 5.34 ± 1.21 | 8.12 | 66.90 | 0.659 |
Total YBOCS score | 19.22 ± 2.95 | 8.36 ± 2.69** | 56.50 | 22.50 ± 4.95 | 20.69 ± 4.35 | 9.58 ± 2.87 | 8.04 | 57.42 | 0.852 |
Variables | Anxiety (n = 111) | Atypical (n = 63) | ||||||
---|---|---|---|---|---|---|---|---|
Enrolment
n (%) | 3 months later
n (%) | Z1
| Enrolment
n (%) | 3 months later
n (%) | 6 months later
n (%) | Z2
| Z3
| |
Disease severity | 2.583**
| 0.674 | 2.435**
| |||||
No assessment | 0 | 0 | 0 | 0 | 0 | |||
Normal | 0 | 5 (4.5) | 0 | 0 | 4 (6.3) | |||
Borderline | 0 | 35 (31.5) | 0 | 0 | 23 (36.5) | |||
Mild | 10 (9.0) | 55 (49.5) | 9 (14.3) | 12 (19.0) | 27 (42.9) | |||
Moderate | 36 (32.4) | 16 (14.5) | 22 (34.9) | 25 (39.7) | 9 (14.3) | |||
Obvious | 45 (40.5) | 0 | 24 (38.1) | 19 (30.2) | 0 | |||
Severe | 12 (10.8) | 0 | 7 (11.1) | 6 (9.5) | 0 | |||
Most severe | 8 (7.3) | 0 | 1 (1.6) | 1 (1.6) | 0 | |||
Overall efficacy | 3.689***
| |||||||
No assessment | 111 | 0 | 63 | 0 | 0 | 0.968 | 2.874**
| |
Obviously improved | 0 | 64 (57.7) | 0 | 0 | 41 (65.1) | |||
Improved | 0 | 39 (35.1) | 0 | 0 | 16 (25.4) | |||
Slightly improved | 0 | 8 (7.2) | 0 | 0 | 6 (9.5) | |||
No change | 0 | 0 | 0 | 61 (96.8) | 0 | |||
Slightly deteriorated | 0 | 0 | 0 | 2 (3.2) | 0 | |||
Deteriorative | 0 | 0 | 0 | 0 | 0 | |||
Obviously deteriorated | 0 | 0 | 0 | 0 | 0 |
Differences in big five personality traits among the BD, atypical BD and simple anxiety groups
Differences in big five personality traits among the three groups
Pairwise comparisons among the three groups
Variables | Typical points low/high | BD (n = 48) Mean ± SD | Atypical (n = 63) Mean ± SD | Anxiety (n = 111) Mean ± SD | F |
---|---|---|---|---|---|
Neuroticism | 20.4/38.8 | 43.63 ± 6.50 | 43.81 ± 5.74 | 42.59 ± 6.78 | 0.291 |
Extraversion | 26/42 | 31.81 ± 6.36 | 32.95 ± 4.79a
| 36.81 ± 4.74b
| 6.863**
|
Openness | 32/47 | 42.31 ± 6.22 | 41.24 ± 6.13c
| 37.41 ± 5.06d
| 5.545**
|
Agreeableness | 30/48 | 34.44 ± 2.89 | 33.76 ± 3.83e
| 39.51 ± 4.41f
| 17.593***
|
Conscientiousness | 36/44 | 34.38 ± 4.05 | 35.67 ± 3.73g
| 39.32 ± 3.87h
| 11.472***
|
Differences in endocrine indices among the BD, atypical BD and simple anxiety groups
Abnormality rates of endocrine indices among the three groups
Variables | BD (n = 48) | Atypical (n = 63) | Anxiety (n = 111) |
χ
2a
|
χ
2b
|
χ
2c
| |
---|---|---|---|---|---|---|---|
n (%) |
n (%) |
n (%) | |||||
HPT | TSH | 12 (25.0) | 18 (28.6) | 3 (2.7) | 0.074 | 9.412**
| 20.227***
|
T3 | 0 (0) | 0 (0) | 0 (0) | – | – | – | |
FT3 | 3 (6.3) | 5 (7.9) | 0 (0) | 2.671 | 6.993**
| 7.012**
| |
T4 | 0 (0) | 0 (0) | 0 (0) | – | – | – | |
FT4 | 3 (6.3) | 5 (7.9) | 0 (0) | 0.158 | 6.993**
| 7.012**
| |
HPA | ACTH | 6 (12.5) | 6 (9.5) | 0 (0) | 0.111 | 7.186**
| 7.132**
|
PTC | 6 (12.5) | 21 (33.3) | 30 (27.0) | 2.517 | 1.566 | 0.591 |
Differences in endocrine indices among the three groups
Variables | BD (n = 48) Mean ± SD | Atypical (n = 63) Mean ± SD | Anxiety (n = 111) Mean ± SD | F | |
---|---|---|---|---|---|
HPT | TSH | 2.80 ± 1.62 | 4.44 ± 2.87a
| 2.14 ± 0.73b
| 11.321***
|
T3 | 2.24 ± 0.42c
| 2.36 ± 0.36 | 1.98 ± 0.36d
| 7.638**
| |
FT3 | 4.45 ± 0.51 | 4.98 ± 0.69e
| 4.94 ± 0.49 f
| 4.995**
| |
T4 | 91.22 ± 19.59 | 92.92 ± 18.43g
| 79.25 ± 10.12h
| 6.820**
| |
FT4 | 17.26 ± 3.30 | 17.07 ± 2.89i
| 15.32 ± 1.82 j
| 4.937*
| |
HPA | ACTH | 21.96 ± 11.06 | 37.06 ± 27.58k
| 41.80 ± 16.64l
| 5.808**
|
PTC | 341.68 ± 151.71 | 544.82 ± 152.71m
| 540.25 ± 121.16n
| 13.325***
|
Pairwise comparison among the three groups
Differences in inflammatory cytokines among the BD, atypical BD and simple anxiety groups
Abnormality rates of inflammatory cytokines among the three groups
Variables | BD (n = 48) | Atypical (n = 63) | Anxiety (n = 111) |
χ
2a
|
χ
2b
|
χ
2c
|
---|---|---|---|---|---|---|
n (%) |
n (%) |
n (%) | ||||
IL-6 | 9(18.8) | 9(14.3) | 3(2.7) | 0.176 | 4.832*
| 7.384**
|
IL-8 | 4(8.3) | 6(9.5) | 0(0) | 0.016 | 7.074**
| 7.132**
|
IL-10 | 0(0) | 0(0) | 0(0) | – | – | – |
TNF | 21(43.8) | 30(47.6) | 15(13.5) | 0.070 | 8.927**
| 18.203***
|
CRP | 3(6.3) | 3(4.8) | 0(0) | 0.052 | 6.993**
| 5.356*
|
Differences in inflammatory cytokine levels among the three groups
Variables | BD (n = 48) Mean ± SD | Atypical (n = 63) Mean ± SD | Anxiety (n = 111) Mean ± SD | F |
---|---|---|---|---|
IL-6 | 3.52 ± 3.54 | 6.42 ± 4.19a
| 2.53 ± 2.72b
| 9.022***
|
IL-8 | 27.92 ± 55.31 | 22.86 ± 40.00 | 24.76 ± 78.82 | 0.025 |
IL-10 | 4.66 ± 0.55 | 3.49 ± 0.86c
| 4.43 ± 0.86d
| 12.193***
|
TNF | 7.69 ± 3.13 | 10.89 ± 7.76e
| 5.67 ± 2.08f
| 8.632***
|
CRP | 2.84 ± 3.38 | 4.44 ± 3.83g
| 2.62 ± 2.85h
| 8.708***
|