How Polarity of the First Episode Affects Clinical Characteristics and the Course of Illnesses of Bipolar I Disorder Patients
Sunanta Chantakarn MD, PhD, MPE1, Kitikan Thana-udom MD1, Kamonporn Wannarit MD1, Teerasakdi Satra MD1
Affiliation : 1 Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To compare clinical characteristics and courses of illness of bipolar I disorder patients in Siriraj Hospital, who
were first presented with either manic or depressive episode.
Materials and Methods : One-hundred and fifty participants with bipolar I disorder who were treated during August 2013
and October 2014. They were divided into two groups by their first mood episode: depressive and manic polarity groups.
Data were collected by semi-structured interviews, Diagnostic Interview for Genetic Studies [DIGS] Thai version and chart
reviews. Clinical characteristics and courses of illness of both groups were analyzed.
Results : There were 94 and 56 patients in the first episode of depressive polarity group and manic polarity group,
respectively. The first episode of depressive polarity group had longer durations of illness and higher numbers of depressive
episodes and history of suicide attempts. Odds ratio showed that the first episode of depressive polarity increased risk for
lifetime history of suicide and poor concentration than the first episode of manic polarity; odds ratio were 3.04 (95% CI 1.45
to 6.37) and 2.78 (95% CI 1.28 to 6.02), respectively.
Conclusion : The polarity of the first episode impact lifetime clinical presentations and illness severity. Physicians should
pay attention on concentration and suicide ideality of bipolar I disorder patients whom first presented with depressive
episode.
Keywords : Bipolar I disorder, First episode, Polarity, Course of illnesses, Suicide
