Abstract
Background and Objectives: Relapse of Bipolar Mood Disorder I BMD (I) is common and causing worsening of patient disability, increasing of cost of disease and decrease in patient performance. With mood stabilizer drugs relapse of disease will reduce and it’s preventable. Drug discontinuation and lowering its dose usually cause relapse. Some rules are important with drug taking like as sleep pattern, drug abuse and emotions. This study will evaluate the effect of these factors in relapse of disease. Purpose: evaluate factors related to relapse of BMD and evaluate relation of relapsing factors with demographic data of patients
Materials and Methods: One hundred and forty patients (86 male and 54 female) with BMD (I) on the base of DSM- IV TR criteria and SCID from three centers of Razi hospital special clinic of Tabriz University of Medical Sciences included randomly for study. All patients had two or greater than two episodes of disease. Related factors were evaluated by interview with patients, their relatives and filling the questionnaires. Relation of relapsing factors and demographic data evaluated. Descriptive and Pearson correlational statistic analysis were done by SPSS soft ware.
Results: Seventy two (51.3%) of patients were in manic phase, 25 (17.9%) were in depression and 43 (30.7%) were in mixed phase of their disease. Clinical feature of disease were psychotic in 52 (37.1%) of patients and others were no psychotic. Severity of disease was high in majority of patients and mean of their young mania scale was 56.38, decreasing drug dose in 18.8%, use of unstabling mood drugs (TCA– neuroleptic) In 56.6%, substance abuse and dependency in 15.7%, somnolence and irregular sleep pattern in 41.4%, low knowledge related to maintenance therapy in 46% and life events (good or bad) in 7.8% Significant relation of relapsing factors and demographic data are as follows. Drug discontinuation were more in women than men (P=0.001), married patient lowered their drug dose more than non married patients (P= 0.03). Divorce patients discontinued their drugs more than others (P=0.05). Severity of depression were higher in old ages and relation between age and Hamilton scale were significant (P=0.03). There was no significant relation between other factors.
Conclusion: Relapse is common in BMD and related to many factors, some are more important like discontinuation of mood stabilizing, decreasing drug dose, changing in sleep pattern, psychological stresses and low knowledge related to their disease. Knowing of these factors and patient and family education are effective in lowering the relapse of disease.