Late Diagnostics of Bipolar Disorder: Impact on Main Characteristics of Disease, Suicidal Behaviour and Social Adaptation Level of Patients

Abstract

The aim was to study the impact of late diagnostics of bipolar disorder (BD) on the main clinical and dynamic indicators, suicidal behavior, the subjective evaluation of social adaptation level, and employment status of patients. Patients and methods: 121 in-patients (38 males, 31.4% and 83 females, 68.6%) with a veried diagnosis of bipolar disorder (according to the ICD-10 criteria) were examined. A comparative evaluation of indicators that could reect the causes and consequences of delayed diagnostics of bipolar disorder was performed. The rst group ( n = 46) included patients with BD veried during the initial visit to a psychiatrist, and the second group ( n = 75) made up patients with late diagnosis of BD. Clinical, psychopathological, follow- up, psychometric, statistical methods were used. Results: delay in the diagnosis of BD was 38%. Comorbid anxiety disorders were the most signicant confounding factor of late diagnostics of BD. Suicidal attempt incidence and the total SBQ-R (The Suicidal Behaviors Questionnaire-Revised) score were higher in cases of late diagnosis of BD ( p < 0.05). In the group with late diagnosis of BD, 17 patients (22.7%) were unemployed due to affective disorder compared to 4 patients (8.7%) with BD diagnosed at the rst visit to psychiatrist ( p < 0.05), and a lower level of subjective evaluation of their social adaptation was revealed ( p < 0.05). Conclusions: late diagnostics of bipolar disorder increases suicide risk and negative impact on the employment status and reduces social adaptation of patients.