Onset episode in a bipolar patient sample: A preliminary study

Abstract

Introduction Bipolar disorder usually has an atypical onset, either with a depressive or a psychotic (non-manic) episode. Potential predictive factors for bipolarity should increase diagnostic accuracy since onset. Objectives Identifying the onset episode type in a Romanian bipolar patient sample. Methods Seventy-two patients diagnosed with bipolar disorder according to ICD-10 diagnostic criteria, admitted in our hospital between 2009 and 2015, were included in this study. For assessing the type of the onset episode, we used the MADRS and YMRS (for affective symptoms) and the PANSS (for psychotic symptoms). Results Out of the 72 bipolar patients, at onset: 24 had a moderate or severe depressive episode (without psychotic features), 19 had a severe depressive episode with psychotic features, 11 had a manic episode with psychotic features, 8 had a manic episode without psychotic features, 6 had the diagnosis of acute polymorphic psychotic disorder (5 without symptoms of schizophrenia and 1 with symptoms of schizophrenia), 3 had the diagnosis of other acute predominantly delusional psychotic disorder and 1 had the diagnosis of acute schizophrenia-like psychotic disorder. Conclusions More than half of the patients included in this study had moderate or severe depressive symptom severity at onset. Identifying predictors for bipolarity in a depressive first episode should aid in more adequate treatment since onset.