The comparison of the patients diagnosed as bipolar affective disoder whose first epizode was depressive episode, with the patients diagnosed as unipolar depressive disorder who developed manic/hypomanic shift under antidepressant treatment and also

İNGİLİZCE ÖZETSUMMARYTitle: The comparison of the patients diagnosed as bipolar affective disoder whose firstepisode was depressive episode, with the patients diagnosed as unipolar depressive disorderwho developed manic / hypomanic shift under antidepressant treatment and also withunipolar depressive patients who did not develope manic / hypomanic shift underantidepressant treatment, in tems of clinical properties and family history of psychiaticillnessAim: In this study our aim was to compare the patients diagnosed as bipolar affective disoderwhose first episode was depressive episode, with the patients diagnosed as unipolar depressivedisorder who developed manic / hypomanic shift under antidepressant treatment and also withunipolar depressive patients who did not develope manic / hypomanic shift under antidepressanttreatment, in tems of clinical properties and family history of psychiatic illnessMethod: 76 patients diagnosed as bipolar disorder, first episode depressive; 61 patients whodeveloped manic shift due to antidepressant drug treatment or ECT and 80 patients diagnosedmajor depressive disorder (Unipolar depression) were evaluated. All the patients were diagnosedusing SCID-I according to the criteria of DSM-IV. Medical records, histories of patients gatheredfrom themselves an their relatives were evaluated retrospectively.Results: The age of onsetin bipolar disorder group (27.2±9.4) was significantly lower than theunipolar depression group (35.4±13.29) but compared to the manic shift group (31.9±12.8) nosignificant difference was found. Bipolar type1 disorder (25.2±8.68) was found to have an earlier3age of onset than bipolar type 2 disorder (38.7±9.1). Compared to the bipolar and unipolar group,the manic shift group had more depressive episodes. The frequency of hospitalisation wasbipolar (68.4%), manic shift group (36.1%) and unipolar group (13.8%), respectively. Thefrequency of melancholic features was highest in the manic shift group (62.3%), second in thebipolar group (57.9%) and thirh in the unipolar group (27.5%). Psychotic features were exhibitedmost by the bipolar group (46.1%), secondly by the manic shift group (11.5%) and thirdly by theunipolar group (1.3%). Atypical features were exhibited by the manic shift group (13.1%),bipolar group (10.5%) and the unipolar group (1.3%), respectively. Prevalence of atemptedsuicide was highest in the bipolar group (39.5%); manic shift group (23%) and the unipolar group(15%) followed respectively. 28.9% of the bipolar group, 24.6% of the manic shift group and8.8% of the unipolar group had a history of psychiatric illness in the second degree relatives.Conclusions: Patients diagnosed with bipolar disorder, first episode depressive had similarclinical and prognostic outcome features compared to the depressive episode of the manic shiftgroup. Compared to the unipolar group, patients diagnosed bipolar disorder, first episodedepressive had different clinical features and prognostic outcomes. Manic shift due toantidepressant treatment may reflect a transition between unipolar and bipolar disorder. Thesefindings support the Notion that in the future, manic\ hypomanic episodes triggered byantidepressant treatment should be classified under bipolar disorders.4