Abstract
Objective: There is a lack of studies that examine prevalence and phenomenology of bipolar disorder in Africa. In literature, a unipolar manic course of illness in particular is reported to be rare. The purpose of this study was to investigate and describe the course of illness and clinical features for a cross-section of patients diagnosed with bipolar disorder attending public hospitals in Limpopo Province, South Africa and to determine the rate of a unipolar manic course in this sample of patients. Method: This was a descriptive, cross-sectional study of patients presenting with a history of mania between October 2009 and April 2010, to three hospitals in Limpopo Province. A purposeful sample of 103 patients was recruited and interviewed using the Affective Disorders Evaluation. Results: This study confirms that a unipolar manic course is indeed much more common than occurrences suggested in present day literature, with 57% of the study sample ever experiencing manic episodes. Patients presenting with a unipolar manic course of illness, as described in this study, may contribute to the search for an etiologically homogeneous sub-group, which presents a unique phenotype for genetic research and the search for genetic markers in mental illness. With a view to future research, a unipolar manic course therefore needs to be considered as a specifier in diagnostic systems in order to increase the awareness of such a course of illness in bipolar disorder. Conclusion: Fifty seven percent (57%) of study subjects had only ever experienced manic episodes, which is in keeping with findings from Africa and other non-Western countries. Identifying etiologically homogenous subgroups in psychiatry can also aid the profession in developing a reliable and valid nosology for psychiatric disorders. We need to consider a unipolar manic course at least a specifier in DSM and ICD.
Highlights
There is a scarcity of studies examining prevalence and phenomenology of bipolar disorder in Africa[1]
The idea for studying bipolar disorder and in particular unipolar mania in South Africa came about in 2006 while the first author was working at Mokopane Hospital, a hospital in rural South Africa, where he noticed that the number of patients presenting with manic symptoms with a diagnosis of bipolar disorder, far outnumbered those presenting in the depressive phase of the illness
A purposeful sample of 103 patients presenting with a history of mania between October 2009 and April 2010, in three hospitals in the Limpopo Province was recruited and interviewed using the Affective Disorders Evaluation (ADE) 49
Summary
There is a scarcity of studies examining prevalence and phenomenology of bipolar disorder in Africa[1]. A unipolar manic course of illness in particular is reported to be rare[2]. The purpose of this study was to investigate and describe the course of illness and the clinical features in patients diagnosed with bipolar disorder attending three public hospitals in Limpopo Province, South Africa and to determine the rate of a unipolar manic course in this sample. Most patients seemed to have a recurrent unipolar manic course; the mania accompanied by severe psychotic symptoms of a schizophrenic nature from the onset of the illness. These patients seldom presented to hospital or out-patient clinics with symptoms of depression
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
