Unipolar mania in western developed countries: Identification and clinical characterisation of cases in France and the United Kingdom.
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1
King's College London, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, United Kingdom
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2
King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, United Kingdom
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3
Paris Diderot University, Centres Experts Troubles Bipolaires & Dépressions Résistantes, France
Background: Unipolar mania (UM) is a putative subtype of bipolar disorder in which individuals experience recurrent episodes of mania but not depression. There have been few studies of UM conducted in western developed countries and no studies in the United Kingdom (UK) (Yazici, 2014). Aims: To identify people with UM in the UK and France and characterise their demographic and clinical characteristics. Method: People with UM were identified using a large urban South London UK psychiatric case register and a retrospective French lifetime bipolar disorder self-report case series. Demographic and clinical characteristics of people with UM were extracted for each group and compared to a matched group of people with bipolar disorder who had experienced depressive episodes. The criteria for UM used was a primary diagnosis of bipolar disorder with a history of at least three manic episodes and no history of depressive or mixed mood episodes, and for the South London Cohort at least 10 years’ clinical follow-up. Results: 7 people with UM were identified from the South London UK psychiatric case register and 19 were identified from the French lifetime bipolar disorder self-report case series. People with Unipolar Mania in the UK case register were significantly less likely to be white British in ethnicity (p=0.03) and were less likely at a trend significance level to have a history of self-harm (p=0.07), but did not differ in other clinical or treatment characteristics. In the French group, people with Unipolar Mania were more likely to be male (p<0.05), more likely to experience a psychotic illness onset (p<0.0001) and to experience more manic episodes (p<0.0001), but experienced fewer suicide attempts (p<0.06). They were also more likely to have a history of atypical antipsychotic (p=0.04) or sodium valproate (p=0.04) treatment but less likely to have history of antidepressant (p=0.0001) or benzodiazepine treatment (p<0.004). Conclusions: Our findings indicate that people with Unipolar mania can be identified in Western European populations. The differences in clinical characteristics and risk profiles identified by this study suggest that Unipolar mania may be a clinically distinct subtype of bipolar disorder.
References
Yazici O (2014). Unipolar mania: a distinct entity? J Affect Disord 152-154: 52-56.
Keywords:
Bipolar Disorder,
Unipolar mania,
subtypes,
characterization,
IDENTIFICATION
Conference:
ISAD LONDON 2017: Perspectives on Mood and Anxiety Disorders: Looking to the future, London, United Kingdom, 6 Jul - 7 Jul, 2017.
Presentation Type:
Poster
Topic:
Diagnosis / Classification
Citation:
Stokes
P,
Yalin
N,
Colasanti
A,
Patel
R,
Etain
B and
Young
A
(2019). Unipolar mania in western developed countries: Identification and clinical characterisation of cases in France and the United Kingdom..
Front. Psychiatry.
Conference Abstract:
ISAD LONDON 2017: Perspectives on Mood and Anxiety Disorders: Looking to the future.
doi: 10.3389/conf.fpsyt.2017.48.00038
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Received:
05 Jun 2017;
Published Online:
25 Jan 2019.
*
Correspondence:
Dr. Paul Stokes, King's College London, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom, paul.r.stokes@kcl.ac.uk