The comparison of sociodemografic features and life quality of patients with bipolar disorder who respond to treatment and who give i̇nadequate response to treatment

Purpose : Aim of this study is to determine medical treatment response, to detect the factors that affect medical treatment response and compare life quailities in the patients with bipolar disorder, whom followed hospitalized or outpatient. Materials and Methods: Between October 2015 and January 2016, 150 patients (age range 18-65) enrolled in Dicle University Psychiatry Department and whom diagnosed as Bipolar Disorder (BPD) 1 or 2 according to DSM-5 and treated at least 2 years, included into the study after consent taken. Patients with maintain treatment for at least 1 year, patients with treatment at least 6 months for acute mania attack and patients with treatment at least 12 weeks for acute depressive attack considered while determining patients. As the treatment condition, patient's last medications to be at least one of them is mood regulation drug and one of them is antipsychiotic drug. 150 patients followed up outpatient or hospitalized, evaluated sectionally and included into the study and grouped as euthymic patients and patients in period attack. 59 of the patients (%39.4) had good response to the treatment and 91 (%60.6) had insufficient response. Totally 4 groups constructed; Group 1: Euthymic patients with good treatment response, Group 2: Patients with insufficient response to maintain treatment, Group 3: Patients in acute mania period with insufficient response to treatment, Group 4: Patients in acute depressive period with insufficient response to treatment. Number of patients was 59, 42, 32, 17 in group 1, 2, 3 and 4, respectively. Consent Form, Sociodemographic Data Form, Young Mania Evaluation Scale, Hamilton Depression Evaluation Scale, Hamilton Anxiety Evaluation Scale, Clinical Global Following Scale, Sheehan Disability Scale, WHO Life Quality Scale Short From (Whoqol-27) applied to the patients. SPSS 18.0 statistical package program is used in data analysis. Findings: In our study, according to examination of sociodemographic datas; there was no significant differecence between groups about age,gender,marital status,education,socio-economic working status,living place,suicid attempt and smoking status; and results were similar( p>0.05). It is determined that in patients group with insufficient treatment response, smoking and alcohol usage status were more common and there was less family support in these groups; and there was statistically significant difference (p<0.05). It is found that psychiotic symptoms compatible with mood status was more common in patients with good response to the treatment. History of starting to treatment lately, many medication trial, no adaptation to medication and leaving medication were more common in patients with insufficient response to treatment, there was significantly differecence. Evaluating drug using status,in patients with insufficient response to treatment; especially in patients with acute mania period, antipsychotic drug usage (AP) was more common. In patients with insufficient response to treatment,especially in patients with acute depression period, antidepressant (AD), benzodiazepine (BZD) usage and ECT treatment ratio were higher and there was statistically significant difference (p<0.05). Among group 2,3 and 4; in patients with insufficient response to treatment, there was more additional diagnosis. According to DSM–5 TR criterias,as additional diagnosis, common anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder,posttraumatic stress disorder and alcohol-drug usage disorder were detected and additional diagnosis were more common in patients with insufficient response to treatment. Among all patient groups; YMDO average point, HDDO average point, HADO total average point, HADO psychiotic and somatic average point, KGI-S average point, SYO work-social-family average point were significantly higher in patients with insufficient response to treatment; and DSOYKO total average point, DSOYKO general-physical-spiritual-social-environmental area points were less; and in national environment area average point was higher. There were statistically significant difference (p<0.05). Discussion and Results: In our study; history of alcohol-drug usage, insufficient family support, existence of additional diagnosis, episode type of first mood disorder, more total number of mood disorder episode, mismatch of psychiotic features with mood status,seasonality, lack of insight, being long time between symptoms and diagnosis, drug incompatibility and leaving medication deemed unresponsiveness predictors. Further studies needed. We think that to detect unresponsiveness predictors and to determine treatment modalities according to that is crucial.