Subthreshold symptoms in bipolar disorder

Abstract

Introduction Bipolar disorder is a severe mental illness characterized by intermittent episodes of mania, depression and mixed states. The presence of residual symptoms, seems to be the common factor in many studies assessing functioning in BD patients. Objective To evaluate the prevalence of residual symptoms (both depressive and manic) in euthymic patients with bipolar disorder and seek for associated factors. Methodology A total of 30 patients with bipolar disorder were enrolled for this study. They were in remission for at least two months. The patients answered the Hamilton Depression Rating Scale and the Disorder Questionnaire Mood Hirschfeld (the MDQ scale). Results The average age of our patients was 43±13 years. Most patients were from a rural area (70%), married (60%) and did not go beyond secondary school level (93.3%). Forty percent (40%) had organic personal history. Social dysfunction was found in 40% of cases, and professional difficulties in 30% of patients. Depressive residual symptoms were found in 33.3% in cases and hypomaniac ones in 26.6%. Residual depressive symptoms were significantly more frequent among married patients and having organic personal history ( P =0.025). The professional difficulties were associated with male gender ( P =0.025) and the poor quality of free interval ( P =0.03). Conclusion These results illustrate that the intercritical phase in bipolar disorder is not really euthymic. These findings are in favour of developing interventions to manage subthreshold symptoms to reduce their impact on social and professional functioning.