Objective: In our clinical observations, single mood stabilizer and demographical properties of the patients, who received maintenance treatment and episode pattern, course and episode properties; are found discrepant than the patients, who experienced single mood stabilizer in association with maintenance treatment. Moreover, a clear research data is not available in literature. In the present study, demographical and clinical properties and disease course and disease progress and episode features among the patients with an anticipated single mood stabilizer and double mood stabilizer are anticipated to be investigated.
Method: In Bakırkoy Professor Mazhar Osman Mental and Neurological Diseases Hospital, Rasit Tahsin Mood Center unit, and outpatient follow-up files of 167 patients over 18 years of age, followed by Bipolar I Diagnosis in association with DSM-IV-TR diagnostic criterions and administered at least one year mood stabilizer are investigated retrospectively. Mental retardation, overall medical conditional disorder and associated other patients with psychiatric disorders were excluded from the study. The patients were divided into groups as single mood stabilizer (lithium (Li) or valproic acid (VPA) or carbamazepine) and double mood stabilizer (lithium and valproic acid) administered patients. There were 136 patients using single medication and 31 patients using double medications. Sociodemographical features such as gender, marital status, employment status, family bipolar disorder history, age and duration of education were inspected. In terms of clinical features initial episode form, episode number, episodes psychotic natures, seasonality features, medication convenience, number of hospital treatment, correlation with suicide attempt situations were all examined. Data derived from the research were analyzed by SPSS (Statistical Package for Social Sciences) for Windows 17.0 program. When the date were assessed Chi-square and t-tests were applied.
Results: When the cohorts were compared as per sociodemographic properties, significantly important variations were detected only in terms of gender (x2=5.869; p=0.014 < 0.05). Among the patients receiving maintenance treatment based on single medication, female gender was found in higher magnitude. Entire episode number of the patients whom are administered double medications (x=6.030) were found higher than the total episode number of the patients who were given single medication (x=3.680) and the difference was found to be statistically significant (p=0,001 <0,05). Hospital enrollment volume of the patients who received double maintenance treatment (x=3.260) was found higher than the patients receiving single maintenance treatment (x=1.770) and the variation between group mean ratios was statistically significant (p=0,006 <0,05). When compared inside themselves, entire episode numbers of patients from single medication groups who used VPA type medication (x=4.650) were found higher than the patients using Li type medication (x=3.370) and the variation were statistically significant (p=0,019 <0,05). Hospitalization number of the patients using VPA type medications (x=2.680) was found higher than the hospitalization number of the patients using Li type medications (x=1.510).
Conclusion: Among the patients possessing single mood stabilizer and the patients using double medication,remarkable sociodemographical differences were not detected. In terms of clinical properties, among the double treatment patients, except hospitalization and intensified episode numbers, no significant variation was found.