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Xuelong Li,1â 3 Yakun Gao,4 Yiyi Liu,1â 3 Ying Wang,1â 3,* Qing Wu1â 3,5,* 1School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Peopleâs Republic of China; 2Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, Peopleâs Republic of China; 3Anhui Mental Health Center, Hefei, Peopleâs Republic of China; 4Affiliated Hospital of Weifang Medical College, Weifang, Peopleâs Republic of China; 5Hefei Fourth Peopleâs Hospital, Hefei, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Ying Wang; Qing Wu, Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, 316 Huangshan Road, Hefei, 230000, Peopleâs Republic of China, Tel +86-13866136686 ; +86-13856919530, Email wyinghf@163.com; wuqinghf@163.comPurpose: Identifying patients with bipolar disorder (BD) in manic states (BD-M) who are at a high risk of physical violence is a matter of clinical concern. This retrospective institution-based study aimed to identify simple, rapid, and inexpensive clinical markers of physical violence in patients with BD-M.Patients and Methods: The anonymized sociodemographic variables (sex, age, years of education, marital status) and clinical ones (weight, height, body mass index, blood pressure, the score of BRMS, number of BD episodes, psychotic symptoms, history of violence, biochemical parameters, and blood routine parameters) of 316 BD-M participants were collected, and the risk of physical violence was identified using the Brøset Violence Checklist (BVC). Difference tests, correlation analyses, and multivariate linear regression analysis were performed to identify clinical markers for the risk of physical violence.Results: The participants were categorized into groups at low (49, 15.51%), medium (129, 40.82%), and high (138, 43.67%) risk of physical violence. The number of BD episodes, serum uric acid (UA), free thyroxine (FT4) levels, history of violence, and monocyte-to-lymphocyte ratio (MLR) differed significantly between groups (all P< 0.05). The number of BD episodes (r=0.152), FT3 (r=0.131) and FT4 (r=0.132) levels, history of violence (r=0.206), and MLR (r=â 0.132) were significantly correlated with the risk of physical violence (all P< 0.05). The existence of history of violence, number of BD episodes, UA, FT4, and MLR were identified as clinical markers of the risk of physical violence in patients with BD-M (all P< 0.05).Conclusion: These identified markers are readily available at initial presentation and may help in the timely assessment and treatment of patients with BD-M.Keywords: bipolar disorder, manic states, risk of physical violence, clinical makers |
