Outcome of Bipolar I (mania) disorders, In Relation with Personality Profile.
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Date
2008-04
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Abstract
This prospective semi structured study evaluated the relations of symptomatology
and outcome of bipolar manic patients with personality vulnerability. Methods: 52 patients of
bipolar (mania) disorder, out of total 430 admitted patients in psychiatry ward, from January
10, to July 9, 2005 were included in the study. The patients with organic diseases or on any
drugs for last two weeks were excluded from the study. All the patients were diagnosed as per
ICD-10 diagnostic criteria. Patients of bipolar mania were administered Young Mania Rating
Scale (YMRS) to assess the severity of mania. The personality traits and disorders were assessed
by the help of ICD-10 module of International Personality Disorder Examination (IPDE). The
stress in preceding one month was evaluated by using 41 items Presumptive Stressful Life Event
Scale. Initial response to lorazepam was monitored to determine outcome categories.
Results: The clinical and demographic variables of the study sample were analyzed with
initial response to IV lorazepam as quick responder (grade-I), moderate and poor responders
(grade II, III). Sociodemographic variables like marital status (x2 = 1.62, df = 2, NS) and
education status (X2 = 4.57, df = 2, NS) did not approach to statistical significance in outcome.
However, the outcome of the low income group patients was significantly better ( X2 = 16.84,
df = 2, p < 0.001). Out of 14 (26.92%) patients of first manic episode, only 3 patients showed
good response to initial lorazepam treatment (Grade I) and 9 and 2 patients assigned outcome
category II and III respectively. Patients with history of multiple episodes had shown better
response (X2=11.59, df=1, p<0.001, highly significant). Presence of stressful life events was
positively correlated with better response to lorazepam treatment (x2==6.73, df=1, p<0.01
significant).
Anxious (avoidant) or dependent traits alone or in combination with emotionally unstable
personality traits in manic patients significantly determined better episode recovery with
lorazepam at one hand proneness for relapses on the other hand.
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Keywords
Bipolar-1 (mania) disorder, Personality traits, outcome, stressful life events
Citation
Gupta L N, Verma K K, Shriniwas. Outcome of Bipolar I (mania) disorders, In Relation with Personality Profile. Dehi Psychiatry Journal. 2008 Apr; 11 (1): 73-78.