Distinct clinical characteristics of familial and solitary patients with bipolar disorder

Abstract

Objective: Major mental disorders including bipolar disorder aggregate in families. There are also non-familial, solitary cases and familial and non-familial cases may differ. Most of the studies regarding familiality in bipolar disorder targeted similar and dissimilar characteristics of the disease within families. There is a lack of studies targeting between subject differences in patients from different families. The aim of this study is to assess and compare clinical characteristics of type I bipolar patients with and without a family history of bipolar disorders. Method: This study was conducted on outpatients of Raşit Tahsin Mood Disorders Centre of Bakırköy Research and Training Hospital. The medical records of 112 participants (69 female, 43 male, mean age: 41.54±11.19, range: 22-75, 64 of which had family history and 48 without family history) with type I Bipolar Disorder were collected. Missing information was obtained by phone interviews from both patients and first degree relatives. Information of the patients without a family history of any psychiatric disorder was checked with a senior family member. Results: Postpartum episode rates, comorbid psychiatric disorders, number of subjects ever had past mixed episodes, and nicotine dependency rates were found to be significantly higher in patients with family history. No significant difference was detected between groups in terms of age, gender, education, age at disease onset, number of episodes, and number of hospitalizations. Conclusions: Comorbidity, postpartum episodes, lifetime mixed episodes, and smoking were found to be higher in patients with family history and thus associated with bipolarity. Postpartum episodes and comorbidities can be expected to be more prevalent in patients with family history. However clinical characteristics should be further investigated in larger samples.

Keywords

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İki uçlu bozukluğu olan ailesel ve münferit hastaların farklı klinik özellikleri

Öz

Amaç: İki uçlu bozukluk da dahil majör ruhsal bozukluklar ailelerde kümelenmektedirler. Ailesel olmayan, tek vakalar da görülmektedir ve ailesel ve ailesel olmayan vakalar klinik özellikler bakımından farklılık gösterebilirler. Aileselliği dikkate alan çalışmaların büyük bölümü aynı aileden hastalarda hastalığın benzer olan ve olmayan özelliklerini incelemişlerdir. Farklı ailelerden olan ve ailesel özelliklerine göre hastalık özelliklerinin karşılaştırıldığı yeterince çalışma yoktur. Bu çalışmada ailesel olan ve olmayan tip I iki uçlu bozukluğu olan hastaların klinik özellikler açısından incelenmesi ve karşılaştırılması amaçlanmıştır. Yöntem: Bu araştırma Bakırköy Prof. Dr. Mazhar Osman Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesine bağlı Raşit Tahsin Duygudurum Merkezi’nde tedavi görmekte olan hastalarla yapıldı. İki uçlu bozukluğu olan 112 hastanın (69 kadın, 43 erkek, ortalama yaş: 41.54±11.19, dağılım aralığı: 22-75, ailesinde hastalık öyküsü olan 64, olmayan 48 hasta) tıbbi kayıtları incelendi ve veriler hastalardan ve birinci derece akrabalarından telefonla teyit edildi. Ailesinde hastalık öyküsü olmayan hastaların ailelerine sorularak ailelede başka hastanın olmadığı doğrulandı. Bulgular: Psikiyatrik ekhastalıklar, doğum sonrası depresyon oranları, nikotin bağımlılığı, karma hastalık dönemi geçirmiş hasta sayısı ve halen antipsikotik kullanan hasta sayısı aile öyküsü olan hasta grubunda istatistiksel olarak anlamlı derecede daha fazla oldukları saptanan özelliklerdi. Hastalık başlangıç yaşı, hastalık dönemi sayıları ve hastaneye yatış sayıları açısından gruplar arasında fark saptanmadı. Sonuç: Psikiyatrik ekhastalık, doğum sonrası depresyon, karma hastalık dönemleri ve sigara kullanma ailesinde hastlalık öyküsü olan hastalarda daha fazla oranda bulundukları tespit edilen klinik özelliklerdir ve iki uçluluk ile ilişkilidirler. Psikiyatrik ekhastalık ve postpartum dönem geçirmeye yatkınlık aile öyküsü olan hastalarda daha fazla görülmesi beklenebilir. Fakat klinik özelliklerin gruplarda farklılık gösterip göstermediğinin belirlenebilmesi için daha başka büyük örneklemli çalışmalar da gerekmektedir.

Anahtar Kelimeler

• Ailesel, ailesel olmayan, iki uçlu bozukluk

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