Identifying Recent Manic Symptoms by Newly Discharged Patients with Bipolar Disorder

Background: Bipolar disorder type I is a chronic and recurrent disease and is considered as the ninth nonfatal disease. Identifying the symptoms of the manic episode, which are more likely detected by patients, increases the ability of psychiatrists in diagnosing this disorder. Methods: In this cross-sectional study, a total of 96 patients with bipolar disorder were enrolled from 2 academic psychiatric centers. Then, using the patients’ medical records, demographic data were collected. Further, both the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview and the Young mania rating scale (Y-MRS) scale were also performed. Then, about 27 to 33 days after discharge, the patients were contacted by phone and the SCID-I interview was conducted again. Meanwhile, to make the patients focus on the period from which they have recently improved, the phrase "the recent period of hospitalization" was added to the interview questions and the symptoms were checked. Results: At the beginning of the hospitalization, the most common symptom in the total population was irritable mood (89.5%): in the male population decreased need for sleep (98.2%), and in the female population irritable mood (97.5%). In addition, in the evaluation, about 1 month later, irritable mood (69.7%) and decreased need for sleep (67.7%) were the most common symptoms detected by the patients. In terms of the predictive value of each symptom to the diagnosis of that symptom by the psychiatrist, the highest positive predictive value was related to the symptoms of irritable mood (95.5%), decreased need for sleep (95.4%), and talkativeness (95.2%). However, the highest negative predictive value was related to the symptom of elevated mood (87.5%). Conclusion: The patients who have passed manic episodes are more able to detect some symptoms of this episode. Despite some limitations, it seems that using these statistical findings in practice may promote clinical assessment and diagnosis of bipolar disorder type I by psychiatrists.