CLINICAL FEATURES OF PRIMARY EPISODE OF BIPOLAR AFFECTIVE DISORDER
About the author:
Mysula Yu. I., Venger O. P.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Bipolar affective disorder (BAD) is one of the most actual problems in modern psychiatry. The incidence of BAR is from 0.6% to 1.0%, with the incidence remaining relatively stable over a long time. Its actuality is caused by significant medical and social consequences: this disease lasts for a lifetime, accompanied by significant impairment of mental functioning not only in the emotional but also in the cognitive spheres, high levels of comorbidity, need of long-term treatment, as well as a significant reduction in life quality and social relations. At the same time, timely diagnosis of BAD is associated with a number of problems due to the polymorphism of the symptomatology and the imperfection of diagnostic approaches; this results from 5 to 10 years between the initial episode of the BAD and the correct diagnosis being made. Therefore, studying the features of clinical phenomenology of the primary episode of BAD is important for the development of prognostic, prophylactic, treatment-rehabilitation measures for this disease. Aim: to study the features of the symptoms of depression in the primary episode of bipolar affective disorder, taking into account the gender factor and clinical variant. Object and methods: we have clinically examined 153 patients with diagnosed with bipolar affective disorder. Results. It was found that the depressive and mixed variants of PE BAD debut had a sudden onset; and the manic – gradual. In the structure of the depressive variant of PE BAD dominated low mood, less frequent manifestations of irritability, decreased emotions and emotional lability. In the manic variant, the most common symptoms were hyperthymia, euphoria and irritability. The mixed type of the debut was characterized by a combination of depressive and manic symptoms. In the depressive variant the whole spectrum of depressive symptoms is present: low mood (100.0%), anhedonia – 40.3%, fatigue – respectively 68.1%, pessimism – 100.0%, feelings of guilt, futility, anxiety or fear – 33.6%, low self-esteem – 89.1%, inability to concentrate and make decisions – 45.4%, thoughts of death or suicide – 79.8%, unstable appetite, weight change – 61.3%, dysomnia – 98.3%. In the manic variant there are some symptoms: anxiety or fear – 52.2%, inability to concentrate and make decisions – 56.5%, thoughts about death or suicide – 8.7%, dysomnia – 30.4%. The mixed variant is closer to depressive, but the prevalence of depressive symptoms is lower: the decreased mood was found in 81.8%, anhedonia – 45.5%, respectively, fatigue – 54.5%, pessimism – 81.8%, feelings of guilt, futility, anxiety or fear – 72.7%, low self-esteem – 81.8%, inability to concentrate and make decisions – 72.7%, thoughts of death or suicide – 63.6%, unstable appetite, weight change – 27.3%, dyssomny – 100.0%. However, no significant prevalence differences of depressive symptoms were found between men and women. Conclusions: differences in the prevalence of clinical manifestations of depression in the primary episode of bipolar affective disorder are determined by the clinical variant.
bipolar affective disorder, primary episode, depression.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 153-157 pages, index UDK 616.895-07-08