P01-243-An open non-randomised study of course and clinical characteristics of bipolar mixed state in comparison with bipolar manic and depressed state in a tertiary hospital

Abstract

Objectives

The study attempts to delineate the clinical correlates (suicidal risk, manic, depressive and psychotic symptom severity) and course characteristics (age of onset and details of past affective episodes) of bipolar mixed state and compare with bipolar manic and bipolar depressed state diagnosed according to ICD-10 Diagnostic Criteria for Research(ICD-10 DCR).

Methodology

The study was carried out in inpatient psychiatry setting of Kasturba Hospital, Manipal, India over a period of 10 months. It was an Open, Non-randomised, Naturalistic study with sequential sampling. The rating scales used were Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Positive and Negative Symptom Scale for Schizophrenia (PANSS) and Beck Scale for suicidal ideation.

Results

A total of 70 subjects were included in the study meeting the criteria of bipolar disorder currently manic, depressed and mixed state according to ICD-10 DCR.

Manic group constituted the majority (n1 = 47) followed by depressed (n2 = 17) and mixed groups (n3 = 6). Mixed group was characterized by preponderance of females, high suicidal intent, high frequency of mood-incongruent psychotic symptoms, illness severity and significant family history.

Conclusion

The study was able to establish some core features that were specific to mixed states. A larger sample size and a prospective follow up study would throw light on the existence of this group as an independent entity.