SOME PREDICTORS OF THE PRIMARY EPISODE OF BIPOLAR AFFECTIVE DISORDERS
DOI:
https://doi.org/10.11603/2415-8798.2019.1.10005Keywords:
bipolar affective disorder, primary episode, heredity, initial factorsAbstract
Problem of bipolar affective disorder is one of the actual problems in modern psychiatry.
The aim of the study – to learn the features of heredity of patients with bipolar affective disorder (BAD) and initial factors, taking into account the gender factor and the variant of the primary episode of the BAD.
Materials and Methods. We studied medical records of 180 men and 222 women with initial BAD episode. Three main variants of the course of the primary episode of BAD are distinguished: with predominance of depressive symptoms (depressive variant) – 79.4 %, with predominance of manic or hypomanic symptoms (manic variant) – 15.7 %, with both depressive and manic symptoms or with fast phase change (mixed variant) – 4.9 %.
Results and Discussion. In patients with a manic variant of the initial episode, the burden of heredity on all mental disorders and alcoholism (47.6 %) was more often than in patients with depressive variant (35.1 %, p<0.05) and mixed (40.0 %, p>0.05) variant of the initial episode. Most often, an unintentional start occurred in the manic variant (61.9 %, p<0.01), less frequently in mixed cases (55.0 %, p<0.01), and most often in depressed (21.4 %) variant. In the depressive variant of the initial episode, the connection between the onset of the disease and the psycho-emotional stress was more frequently detected – in 70.8 % of the subjects compared with 31.7 % of the manic and 35.0 % of the mixed variant of the initial episode (p<0.01).
Conclusions. In patients with BAD we revealed insignificant burdens of heredity for BAD with a significant burden of heredity for mental disorders and addicts in general, and in patients with a manic variant of the initial episode, significantly more frequent manifested heredity for all mental disorders and alcoholism. In patients with a depressive variant, the primary episode is significantly more associated with the effect of psycho-emotional stress, and in patients with a manic and mixed variant is more often not associated with the action of external factors. These features should be taken into account when developing diagnostic, therapeutic, rehabilitation and preventive measures.
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