2194 – Association Between Lower Limb Edema And Acute Mania

Abstract

Introduction

Lower Limb Edema (LLE) is a common finding among admitted psychiatric patients in general and is associated with agitated state. Possible explanations include general medical condition and treatment adverse effects.

Objectives

To determine association between LLE and the type of psychiatric exacerbations among hospitalized patients.

Methods

A retrospective study was conducted using medical data from 2529 patients admitted to Geha mental Health Center between 2002 and 2012. Incident cases of LLE and the type of psychiatric exacerbation were included. A logistic regression models were used to estimate the odds ratio (OR) for LLE among patients admitted to psychiatric hospital for manic episode, psychotic episode or depressive episode.

Results

Lower limb edema was diagnosed in 95 of 2529 admitted patients (3.8%). Edema was found in 38 of 366 cases of manic episode (10.4%), 41 of 1563 cases of psychotic episode (2.6%) and 16 of 600 cases of depressive episode (2.7%).OR of LLE was 4.3 (95% CI, 2.7-6.7) for manic episode vs. psychotic episode and 4.2 (95% CI, 2.3-7.6) for manic episode vs. depressive episode. Applying a multivariate model adjusted for age, sex, number of past admissions, length of hospitalization, substance abuse, cardiovascular and endocrine co-morbidities, pulse, Positive and Negative Syndrome Scale (PANSS) score and blood test results did not substantially altered the risk for LLE associated with manic episode vs. psychotic episode(OR, 4.1 [95% CI, 1.6-9.9]).

Conclusions

Admission to psychiatric hospital for manic episode was associated with significantly increased risk for LLE.