BIPOLAR DISORDER IN RURAL POPULATION

Abstract

Introduction: Mental disabilities were the second leading cause of disease burden in terms of years lived with disability (YLDs) and the sixth major cause of disability-adjusted life-years (DALYs) in the world in 2017, creating a great challenge to health systems, especially in lower- and medium income nations. This study was carried out with an aim to evaluate the bipolar disorder course in rural area. Data on the progression of bipolar disorder were collected in a group of patients previously diagnosed of bipolar disorder. Material and Methods: Cases of bipolar disorder were diagnosed with a psychiatric condition, using the ICD-10 system. The bipolar disorder (previously manic-depressive psychosis, manic or circular) requirement is fulfilled by 24 patients. A follow-up assessment of these patients was performed at their place of residence over a span of 6 months. Frequent travel to rural areas was included in this study. Written informed consent was obtained from all the participants. The Schedule for Affective Disorders and Schizophrenia-Lifetime variant (SADS-L) and the Longitudinal Interval Follow-up Tests (LIFE) were used to assess cases. Results: A total of 24 patients who met the criteria were included in the study. No death was observed in the follow up visits. direct interview was carried out in 24 cases. There were 10 male and 14 females included in the study. Mean age of onset of bipolar disorder was 29 ± 13.45 years. Duration of illness was observed as 11.6 ± 7.58 years. Number of episodes during study was 5.4 ± 3.8. Manic episodes (weeks) were 12.4 ± 11.9. Depressive episodes (weeks) were 18.5 ± 17.6 and Mixed episodes (weeks) were 9.8 ± 12.9. Three (12.5%) patients were having single lifetime episode, 13(54.17%) experienced 2-9 episodes and 4 (16.67%) cases had >10 episodes. Rapid cycling was observed in 4 (6.67%). 13 (54.17%) were hospitalised at least once in their lifetime and 3 (12.5%) of the cases were never taken any treatment. Conclusion: This disorder started predominantly with mania, and study indicates that mood at the outset of the study may forecast the polarity of potential recurrence. Keywords: mania, bipolar disorder, Depressive episodes, Manic episodes and Mixed episodes