中国10~24岁青少年双相障碍疾病负担现状及趋势分析

赵子赫; 朱嘉雯; 黄倩玲; 曾智

doi:10.16835/j.cnki.1000-9817.2025041

中国10~24岁青少年双相障碍疾病负担现状及趋势分析

doi: 10.16835/j.cnki.1000-9817.2025041

南京中医药大学卫生经济管理学院，江苏 210023

基金项目:

国家自然科学基金项目 82101602

详细信息

作者简介:
赵子赫(2000-)，男，山东潍坊人，在读硕士，主要研究方向为社会医学与卫生事业管理

通讯作者:
曾智，E-mail：zengzhinju@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 B844.2 R174^+.6
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-22
- 修回日期: 2024-11-28
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Analysis of disease burden for bipolar disorder in Chinese adolescents aged 10-24 years and trend prediction

School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing (210023), Jiangsu Province, China

摘要

摘要: 目的分析1990—2021年中国10~24岁青少年双相障碍疾病负担状况及变化趋势，为双相障碍的防治工作提供理论依据。方法选取全球疾病负担(GBD)数据库2021年的最新数据，使用Joinpoint回归模型、年龄—时期—队列(APC)模型和贝叶斯年龄—时期—队列(BAPC)模型对中国青少年双相障碍标化发病率和标化失能调整寿命年(DALY)率等指标进行分析和预测，并计算平均年度变化百分比(AAPC)。结果 1990—2021年青少年双相障碍疾病总体标化发病率(1990年：22.92/10万，2021年：23.17/10万)呈上升趋势(AAPC=0.03，t=8.20，P < 0.01)，标化DALY率(1990年：33.61/10万，2021年：33.76/10万)变化趋势较为平缓(AAPC=0.01，t=0.99，P=0.32)。1990—2021年女生标化发病率和标化DALY率均大于男生(χ²=16.38，P < 0.01)。1990—2021年中国10~24岁青少年双相障碍发病率和DALY率的净漂移值分别为-0.23%和-0.22%。中国10~24岁青少年双相障碍发病率在15~19岁最高，为33.14/10万；20~24岁DALY率最高，为57.26/10万。中国10~24岁青少年双相障碍发病风险和DALY风险RR值均在2017—2021年达到最低，分别为0.99(95%CI=0.97~1.00)和0.98(95%CI=0.97~0.99)(P值均 < 0.05)。中国10~24岁青少年双相障碍发病风险和DALY风险RR值均在2000—2004年出生队列达到最低，均为0.86(95%CI=0.84~0.87)(P值均 < 0.05)。预计2022—2031年中国10~24岁青少年双相障碍总体标化发病率和标化DALY率均呈上涨趋势，到2031年分别涨至24.10/10万和34.90/10万。结论 1990—2021年中国青少年双相障碍标化发病率和标化DALY率均呈上涨趋势。应重点关注女性青少年群体，控制15~19岁青少年双相障碍标化发病率和20~24岁青少年双相障碍标化DALY率，增强对青少年双相障碍的关注和筛查。
- 双相障碍 /
- 患病代价 /
- 失能调整生命年 /
- 青少年
Abstract: Objective To analyze the burden of bipolar disorder among adolescents aged 10-24 in China from 1990 to 2021 and its trend of change, so as to provide theoretical basis for the prevention and treatment of bipolar disorder. Methods The latest data from the Global Burden of Disease (GBD) database in 2021 were selected. The Joinpoint regression model, age-period-cohort (APC) model, and bayesian age-period-cohort (BAPC) model were used to analyze and predict indicators such as the age-standardized incidence rate and age-standardized disability-adjusted life year (DALY) rate of bipolar disorder among Chinese adolescents, and the average annual percent change (AAPC) was calculated. Results From 1990 to 2021, the overall age-standardized incidence rate (1990:22.92/100 000, 2021:23.17/100 000) showed an upward trend (AAPC=0.03, t=8.20, P < 0.01) and change trend of age-standardized DALY rate (1990:33.61/100 000, 2021:33.76/100 000) was relatively flat (AAPC=0.01, t=0.99, P=0.32). From 1990 to 2021, age-standardized incidence rate and age-standardized DALY rate of girls were higher than boys (χ²=16.38, P < 0.01). The net drift values for the incidence rate and DALY rate of bipolar disorder among Chinese adolescents aged 10-24 years were -0.23% and -0.22%, respectively. The highest incidence rate of bipolar disorder among Chinese adolescents aged 10-24 years was observed in the 15-19 age group, with a rate of 33.14/100 000; the highest DALY risk was in the 20-24 age group, with a rate of 57.26/100 000. The lowest incidence risk and DALY risk RR values for bipolar disorder among Chinese adolescents aged 10-24 years were observed in 2017-2021, with RR values of 0.99 (95%CI=0.97-1.00) and 0.98 (95%CI=0.97-0.99), respectively (P < 0.05). Similarly, the lowest incidence risk and DALY risk RR values for this age group were observed in the 2000-2004 birth cohort, both of which were 0.86 (95%CI=0.84-0.87) (P < 0.05). It was projected that the overall age-standardized incidence rate and age-standardized DALY rate of bipolar disorder among Chinese adolescents aged 10-24 years will continue to increase from 2022 to 2031, reaching 24.10/100 000 and 34.90/100 000, respectively, by 2031. Conclusions From 1990 to 2021, both the age-standardized incidence rate and age-standardized DALY rate of bipolar disorder among Chinese adolescents shows an upward trend. Special attention should be given to female adolescents, with a focus on controlling the age-standardized incidence rate of bipolar disorder among 15-19 year-old adolescents and the age-standardized DALY rate among 20-24 year-old ones. Efforts should be enhanced to increase awareness and screening for bipolar disorder among adolescents.
- Bipolar disorder /
- Cost of illness /
- Disability-adjusted life year /
- Adolescent
注释:

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图 1 中国1990—2021年10~24岁青少年双相障碍标化发病率和标化DALY率分布

Figure 1. Distribution of age-standardized incidence and age-standardized DALY rate of bipolar disorder among adolescents aged 10-24 years from 1990 to 2021 in China

下载: 全尺寸图片幻灯片

图 2 中国1990—2021年青少年双相障碍发病率与DALY率时期和队列效应

注： A、B为时期效应，C、D为队列效应。

Figure 2. Period and cohort effects on the incidence rate and DALY rate of bipolar disorder among Chinese adolescents from 1990 to 2021

下载: 全尺寸图片幻灯片

图 3 中国2022—2031年10~24岁青少年双相障碍标化发病率和标化DALY率预测

Figure 3. Forecast of age-standardized incidence and age-standardized DALY rate of bipolar disorder among adolescents aged 10-24 years from 2022 to 2031 in China

下载: 全尺寸图片幻灯片

参考文献(42)

[1]	温福华, 周焕南, 涂南萍, 等. 家庭功能与中小学生睡眠障碍及抑郁症状的关系[J]. 中国学校卫生, 2023, 44(5): 664-667. doi: 10.16835/j.cnki.1000-9817.2023.05.006 WEN F H, ZHOU H N, TU N P, et al. Associations of family functioning with sleep disturbance and depressive symptoms among primary and secondary school students[J]. Chin J Sch Health, 2023, 44(5): 664-667. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.05.006
[2]	BANSEMA C H, VERMEIREN R R J M, DE SOET R, et al. A systematic review exploring characteristics of youth with severe and enduring mental health problems (SEMHP)[J]. Eur Child Adolesc Psychiatry, 2024, 33(5): 1313-1325. doi: 10.1007/s00787-023-02216-6
[3]	YANG W, HU D, ZHENG B, et al. Rash caused by lurasidone in old Chinese patient with bipolar disorder: case-based review[J]. BMC Psychiatry, 2024, 24(1): 491. doi: 10.1186/s12888-024-05668-5
[4]	VAN METER A, MOREIRA A L R, YOUNGSTROM E. Updated Meta-analysis of epidemiologic studies of pediatric bipolar disorder[J]. J Clin Psychiatry, 2019, 80(3): 18r12180.
[5]	LIU L, MENG M, ZHU X, et al. Research status in clinical practice regarding pediatric and adolescent bipolar disorders[J]. Front Psychiatry, 2022, 13: 882616. doi: 10.3389/fpsyt.2022.882616
[6]	LI F, CUI Y, LI Y, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17 524 individuals[J]. J Child Psychol Psychiatry, 2022, 63(1): 34-46. doi: 10.1111/jcpp.13445
[7]	DENG H, WEN F, XU H, et al. Prevalence of affective disorders in Chinese school-attending children and adolescents aged 6-16 based on a national survey by MINI-Kid[J]. J Affect Disord, 2023, 331: 192-199. doi: 10.1016/j.jad.2023.03.060
[8]	MCGINTY K R, JANOS J, SEAY J, et al. Comparing self-reported quality of life in youth with bipolar versus other disorders[J]. Bipolar Disord, 2023, 25(8): 648-660. doi: 10.1111/bdi.13320
[9]	KHOUBAEVA D, DIMICK M, TIMMINS V H, et al. Clinical correlates of suicidality and self-injurious behaviour among Canadian adolescents with bipolar disorder[J]. Eur Child Adolesc Psychiatry, 2023, 32(1): 41-51. doi: 10.1007/s00787-021-01803-9
[10]	COMSA M, ANDERSON K N, SHARMA A, et al. The relationship between sleep and depression and bipolar disorder in children and young people[J]. BJPsych Open, 2022, 8(1): e27. doi: 10.1192/bjo.2021.1076
[11]	CUI X, XUE T, ZHANG Z, et al. A bibliometric and visual analysis of cognitive function in bipolar disorder from 2012 to 2022[J]. Ann Gen Psychiatry, 2024, 23(1): 13. doi: 10.1186/s12991-024-00498-x
[12]	SESSO G, BRANCATI G E, MASI G. Comorbidities in youth with bipolar disorder: clinical features and pharmacological management[J]. Curr Neuropharmacol, 2023, 21(4): 911-934. doi: 10.2174/1570159X20666220706104117
[13]	YAPICI ESER H, TAŞKIRAN A S, ERTINMAZ B, et al. Anxiety disorders comorbidity in pediatric bipolar disorder: a Meta-analysis and Meta-regression study[J]. Acta Psychiatr Scand, 2020, 141(4): 327-339. doi: 10.1111/acps.13146
[14]	WOODWARD D, WILENS T E, YULE A M, et al. Examining the clinical correlates of conduct disorder in youth with bipolar disorder[J]. J Affect Disord, 2023, 329: 300-306. doi: 10.1016/j.jad.2023.02.119
[15]	SIMONETTI A, KURIAN S, SAXENA J, et al. Cortical correlates of impulsive aggressive behavior in pediatric bipolar disorder[J]. Front Psychiatry, 2021, 12: 674707. doi: 10.3389/fpsyt.2021.674707
[16]	GBD 2021 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021[J]. Lancet, 2024, 403(10440): 2133-2161. doi: 10.1016/S0140-6736(24)00757-8
[17]	马晓梅, 王瑾瑾, 裴兰英, 等. 中国青少年1990与2019年HIV/AIDS疾病负担性别差异[J]. 中国学校卫生, 2022, 43(10): 1579-1582. doi: 10.16835/j.cnki.1000-9817.2022.10.032 MA X M, WANG J J, PEI L Y, et al. Gender disparities in epidemiological trend of HIV/AIDS disease burden among Chinese adolescents from 1990 to 2019[J]. Chin J Sch Health, 2022, 43(10): 1579-1582. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.10.032
[18]	NING W, LIU J, LU Y, et al. Trends in the disease burden and risk factors of women's cancers in China from 1990 to 2019[J]. Int J Public Health, 2024, 69: 1607245. doi: 10.3389/ijph.2024.1607245
[19]	关云琦, 王浩, 龚巍巍, 等. 1990—2019年浙江省抑郁障碍疾病负担和危险因素变化趋势研究[J]. 中国慢性病预防与控制, 2024, 32(9): 681-686. GUAN Y Q, WANG H, GONG W W, et al. Trend of disease burden and risk factors of depressive disorder disease in Zhejiang Province from 1990 to 2019[J]. Chin J Prev Control Chron Dis, 2024, 32(9): 681-686. (in Chinese)
[20]	张偲莹, 高宗石, 吴丽宏, 等. 中国1990—2019年儿童青少年哮喘疾病负担变化趋势[J]. 中国学校卫生, 2022, 43(1): 123-128. doi: 10.16835/j.cnki.1000-9817.2022.01.028 ZHANG S Y, GAO Z S, WU L H, et al. Trends in the asthma burden among children and adolescents in China from 1990-2019[J]. Chin J Sch Health, 2022, 43(1): 123-128. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.01.028
[21]	CHERNYAVSKIY P, LITTLE M P, ROSENBERG P S. A unified approach for assessing heterogeneity in age-period-cohort model parameters using random effects[J]. Stat Methods Med Res, 2019, 28(1): 20-34. doi: 10.1177/0962280217713033
[22]	陆地, 曾智, 朱迪, 等. 中国10~24岁青少年进食障碍疾病负担现状及趋势预测[J]. 中国学校卫生, 2024, 45(8): 1186-1190, 1194. doi: 10.16835/j.cnki.1000-9817.2024252 LU D, ZENG Z, ZHU D, et al. Current status and trend prediction of the disease burden of eating disorders among Chinese adolescents aged 10-24 years[J]. Chin J Sch Health, 2024, 45(8): 1186-1190, 1194. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024252
[23]	MULLINS N, FORSTNER A J, O'CONNELL K S, et al. Genome-wide association study of more than 40 000 bipolar disorder cases provides new insights into the underlying biology[J]. Nat Genet, 2021, 53(6): 817-829. doi: 10.1038/s41588-021-00857-4
[24]	ROBINSON N, BERGEN S E. Environmental risk factors for schizophrenia and bipolar disorder and their relationship to genetic risk: current knowledge and future directions[J]. Front Genet, 2021, 12: 686666. doi: 10.3389/fgene.2021.686666
[25]	中华人民共和国教育部关于印发《中小学心理健康教育指导纲要》的通知[EB/OL]. (2002-09-02)[2024-11-26]. http://www.moe.gov.cn/jyb_xxgk/gk_gbgg/moe_0/moe_8/moe_27/tnull_450.html.
[26]	中华人民共和国国家卫生计生委等22个部门联合印发《关于加强心理健康服务的指导意见》[EB/OL]. (2017-01-18)[2024-11-26]. http://www.nhc.gov.cn/jkj/s5889/201701/db8368db61894d84b4148a44aa3602f5.shtml.
[27]	国家疾病预防控制局. 关于印发健康中国行动——儿童青少年心理健康行动方案(2019—2022年)的通知[EB/OL]. (2019-12-26)[2024-11-26]. http://www.nhc.gov.cn/jkj/tggg1/201912/6c810a8141374adfb3a16a6d919c0dd7.shtml.
[28]	沈其杰, 刘铁榜, 张鸿燕, 等. 双相障碍防治指南[M]. 北京: 北京大学医学出版社, 2007: 30-66. SHEN Q J, LIU T B, ZHANG H Y, et al. Guidelines for the prevention and treatment of bipolar disorder[M]. Beijing: Peking University Medical Press, 2007: 30-66. (in Chinese)
[29]	中华人民共和国国家卫生健康委员会办公厅关于印发精神障碍诊疗规范(2020年版)的通知[EB/OL]. (2020-12-07)[2024-11-26]. http://www.nhc.gov.cn/yzygj/s7653p/202012/a1c4397dbf504e1393b3d2f6c263d782.shtml.
[30]	IQBAL J, HUANG G D, XUE Y X, et al. Role of estrogen in sex differences in memory, emotion and neuropsychiatric disorders[J]. Mol Biol Rep, 2024, 51(1): 415. doi: 10.1007/s11033-024-09374-z
[31]	ARAGNO E, FAGIOLINI A, CUOMO A, et al. Impact of menstrual cycle events on bipolar disorder course: a narrative review of current evidence[J]. Arch Womens Ment Health, 2022, 25(2): 257-266. doi: 10.1007/s00737-022-01217-9
[32]	MENCULINI G, BALDUCCI P M, ATTADEMO L, et al. Environmental risk factors for bipolar disorders and high-risk states in adolescence: a systematic review[J]. Medicina, 2020, 56(12): 689. doi: 10.3390/medicina56120689
[33]	HE Y, CHEN S S, XIE G D, et al. Bidirectional associations among school bullying, depressive symptoms and sleep problems in adolescents: a cross-lagged longitudinal approach[J]. J Affect Disord, 2022, 298(Pt A): 590-598. http://pubmed.ncbi.nlm.nih.gov/34800574/
[34]	张家帅, 左霞云, 余春艳, 等. 性别角色态度与青少年抑郁的关联[J]. 中国学校卫生, 2022, 43(2): 181-184, 189. doi: 10.16835/j.cnki.1000-9817.2022.02.005 ZHANG J S, ZUO X Y, YU C Y, et al. Relationship between gender role attitudes and depression among adolescents[J]. Chin J Sch Health, 2022, 43(2): 181-184, 189. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.02.005
[35]	TANG X, TANG S, REN Z, et al. Prevalence of depressive symptoms among adolescents in secondary school in mainland China: a systematic review and Meta-analysis[J]. J Affect Disord, 2019, 245: 498-507. doi: 10.1016/j.jad.2018.11.043
[36]	SCOTT J, GRAHAM A, YUNG A, et al. A systematic review and Meta-analysis of delayed help-seeking, delayed diagnosis and duration of untreated illness in bipolar disorders[J]. Acta Psychiatr Scand, 2022, 146(5): 389-405. doi: 10.1111/acps.13490
[37]	KERAMATIAN K, PINTO J V, SCHAFFER A, et al. Clinical and demographic factors associated with delayed diagnosis of bipolar disorder: data from health outcomes and patient evaluations in bipolar disorder (HOPE-BD) study[J]. J Affect Disord, 2022, 296: 506-513. doi: 10.1016/j.jad.2021.09.094
[38]	DILER R S, MERRANKO J A, HAFEMAN D, et al. Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder[J]. J Affect Disord, 2022, 302: 185-193. doi: 10.1016/j.jad.2022.01.058
[39]	XU Z, GAHR M, XIANG Y, et al. The state of mental health care in China[J]. Asian J Psychiatr, 2022, 69: 102975. doi: 10.1016/j.ajp.2021.102975
[40]	MARQUES DE MIRANDA D, DA SILVA ATHANASIO B, SENA OLIVEIRA A C, et al. How is COVID-19 pandemic impacting mental health of children and adolescents?[J]. Int J Disaster Risk Reduct, 2020, 51: 101845. doi: 10.1016/j.ijdrr.2020.101845
[41]	LORKIEWICZ P, WASZKIEWICZ N. Is SARS-CoV-2 a risk factor of bipolar disorder?A narrative review[J]. J Clin Med, 2022, 11(20): 6060. doi: 10.3390/jcm11206060
[42]	中华人民共和国教育部等十七部门关于印发《全面加强和改进新时代学生心理健康工作专项行动计划(2023—2025年)》的通知[EB/OL]. (2023-04-27)[2024-11-26]. http://www.moe.gov.cn/srcsite/A17/moe_943/moe_946/202305/t20230511_1059219.html.