Comparison of socio-demographic and clinical factors between “unipolar mania” and bipolar affective disorder

Abstract

Background: Bipolar Affective Disorder is defined as an affective or mood illness characterised by distinct episodes of elevated mood and sad mood. However, many patients report recurrent episodes of mania but no depressive episodes usually termed as Unipolar Mania. Our study aimed to identify Unipolar Mania among patients diagnosed with Bipolar Affective Disorder and assess any difference in the clinical and socio-demographic profile between the two groups. Material and methods: This cross-sectional observational study was conducted between April 2020 and March 2021 at the outpatient clinic of a tertiary care medical college hospital. Patients aged >18 years and diagnosed with Bipolar Affective Disorder as per ICD-10 criteria constituted the study population. Patients with a history of any medical illness that may significantly influence CNS function or structure as judged by clinical evidence were excluded. Results: A total of 52 patients were included in the present study after obtaining informed consent, 26 patients each in both groups. The mean age of patients in the Unipolar Mania (UM) group was 38.77±12.42 yrs, and Bipolar Affective Disorder (BPAD) group was 41.15±12.47yrs. The younger age of onset was noted among UM group (25.62±5.31) compared to the BPAD group (28.69±6.29). Psychotic symptoms in the first episode, suicidal attempts, comorbid anxiety disorder, substance use disorder and medical illness were more common among the BPAD group. In contrast, the seasonality was more common among UM group. There was no significant difference between the two groups regarding the number of episodes, the number of psychotic episodes, and mood-congruent psychotic episodes. The Childhood Trauma Questionnaire score was almost similar in both groups. Conclusion: There were no significant differences between the Unipolar Mania (UM) group and Bipolar Affective Disorder (BPAD) group regarding clinical and socio-demographic variables. Unipolar mania, perhaps, is not a distinct nosological disorder. Unipolar mania could be considered a course specifier similar to how rapid cycling, seasonality, and peripartum onset mood disorders are considered rather than a separate nosological entity.