Sociodemographic and clinical features of antidepressant-induced hypomanic and manic switch in patients with bipolar disorder

Antidepresan tedavi ile hipomanik/manik kayma gösteren bipolar bozukluk hastalarında sosyodemografik ve klinik özellikler Amaç: Bu çalışmanın amacı, antidepresan ilaçlarla tedavi sırasında hipomanik/manik kayma gözlenen bipolar bozukluk hastalarının sosyodemografik, ailesel, çocukluk çağı ve bazı klinik özelliklerinin saptanmasıdır. Yöntem: DSM-IV-TR’ye göre bipolar bozukluk tanısı konan 161 hasta çalışmaya alınmıştır. Çalışma, geriye dönük dosya tarama çalışmasıdır. Poliklinik ya da servis takipleri sırasında, antidepresan tedaviye bağlı olarak manik ya da hipomanik kayma gözlenen (n=41, %25.4) ve gözlenmeyen (n=120, %74.6) hastaların sosyodemografik, ailesel, çocukluk çağı ve bazı klinik özellikleri karşılaştırılmıştır. Hasta bilgileri, bipolar polikliniğimizde kullanılmakta olan Türkiye Psikiyatri Derneği Duygudurum Bozuklukları Çalışma Birimi’nin hasta kayıt formlarından elde edilmiştir. Bulgular: Kayma olan grupta hastalığın ilk dönemi daha sıklıkla depresif dönem olarak belirlendi. Kayma olan grupta çocukluk çağı özelliklerinden sezaryen doğum ve enürezis nokturna daha sıktı. Diğer özellikler açısından gruplar arasında fark saptanmadı. Tartışma ve Sonuç: Klinisyenler ilk dönemi depresif dönem olan hastalarda hipomanik/manik kayma açısından dikkatli olmalıdırlar. Diğer iki bulgumuz olan sezaryen doğum ve enürezis nokturna, etiyolojiye ışık tutabilecek yeni çalışmaların planlanması için ipuçları taşıması açısından önemli olabilir.

Antidepresan tedavi ile hipomanik/manik kayma gösteren bipolar bozukluk hastalarında sosyodemografik ve klinik özellikler

Sociodemographic and clinical features of antidepressant-induced hypomanic and manic switch in patients with bipolar disorder Objective: The aim of this study was to identify sociodemographic, familial, childhood and various clinical characteristics of bipolar disorder patients in whom hypomanic/manic switches had been observed during treatment with antidepressant drugs. Methods: One hundred sixty-one patients diagnosed with bipolar disorder on the basis of DSM-IV-TR were included. The study was a retrospective chart review. The sociodemographic, familial, childhood and various clinical characteristics of patients with manic or hypomanic switches (n=41, 25.4%) observed in association with antidepressant treatment during polyclinic or ward monitoring, or patients without switches (n=120, 74.6%) were compared. Patient data were obtained from Psychiatric Association of Turkey Mood Disorders Branch patient record forms. Results: The first disease episode in the switch group was more commonly a depressive one. Cesarean birth and enuresis nocturna were more common childhood characteristics in the switch group. No difference was determined between the groups in terms of other characteristics. Conclusion: Physicians should be careful in terms of hypomanic/manic switch in patients whose first episode is a depressive one. Our other two findings, cesarian birth and enuresis nocturna, may be significant in terms of suggesting clues for the planning of new studies illuminating the etiology.

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