Clinical and evolutionary characteristics of bipolar disorder according to the polarity of the first episode

BACKGROUND: The polarity of the inaugural episode seems to determine the clinical and evolutionary profile of bipolar disorder. AIM: To study the clinical and evolutionary characteristics bipolar disorder according to the polarity of the first episode. METHODS: We undertook a retrospective, descriptive and comparative study including all the patients reached of bipolar disorder I and II (DSM IV TR) who were hospitalized between January 1 2000 and December 31 2006. The minimal duration of follow-up was 4 years. Patients were divided into two groups according to the polarity of the first episode: maniac or hypomaniaque and depressive. The characteristics sociodemographic, clinical, evolutionary and therapeutic were raised and compared between the two groups. RESULTS: The sample was composed of 38 patients (23 men and 15 women). The first episode was of polarity maniac in 57.89% of cases. This mode of beginning was related to a later polarity preferentially maniac, more often punctuated of characteristics psychotics with a sur representation of the addictives conduits and bipolar disorder of type I an episode index of depressive polarity was associated to more chronic evolution, marked by a stronger recurrence of episodes particularly depressive episodes, with a raised suicidal risk and a high representation of the bipolar disorder II. CONCLUSION: The clinical and evolutionary profile of the bipolar disorder seems strongly related to the polarity of the first episode. The strategies of prevention must take account of the inaugural polarity.