Frequency Of Relapse in Bipolar Affective Disorder MTI Ayub Teaching Hospital Abbottabad Khyber Pakhtunkhwa Pakistan.

Abstract

Bipolar Affective Disorder BPAD is a severe mental illness marked by recurrent episodes of mania/hypomania, depression, or mixed states. It affects 2-4% of the global population, making it the sixth leading cause of disability worldwide. The Global Burden of Disease Study 2013 estimated that 48.8 million people suffered from BPAD, with a higher prevalence in women and individuals aged 25–29 years. BPAD is associated with elevated suicide risk, psychiatric comorbidities, and substantial social and economic burdens. The treatment of BPAD is essential to prevent severe complications, including relapse. Objective: To determine the frequency of relapse in patients diagnosed with bipolar affective disorder at Ayub Teaching Hospital, Abbottabad. Study Design: A cross-sectional descriptive study was conducted to assess the frequency of relapse in patients with bipolar affective disorder. The study was carried out at the Department of Psychiatry, Ayub Teaching Hospital, Abbottabad, Pakistan, from July 1st to December 31st, 2022. The study included 80 patients aged between 18–60 years diagnosed with bipolar affective disorder, both male and female, under outpatient follow-up treatment for at least one month. Patients with schizophrenia and those unable to communicate were excluded. Methods: Data collection involved structured proformas that recorded demographic details, bipolar disorder subtype, and relapse status. The relapse was defined as the return of full syndrome criteria for mania, mixed episodes, or depression following any duration of remission. The collected data were analyzed using SPSS version 10.0, with descriptive statistics, including frequencies, percentages, and mean ± standard deviation for quantitative variables. Results: Demographics: The mean age of patients was 33.96±13.97 years, with a mean weight of 55.50±7.88 kg. 55% of the patients were male, and 45% were female. Bipolar Affective Disorder Subtypes: 45% of patients had depression, 22.5% had mania, 27.5% had mixed episodes, and 5% had hypomania. Relapse Frequency: 68.8% of the patients experienced relapse, while 31.3% did not. Age Distribution: 56.3% of patients were under 30 years, and 43.8% were aged 30 years or older. Gender and Bipolar Subtypes: Males showed higher rates of mania and mixed episodes, while females were more likely to have depression. Relapse by Gender: Males had a relapse rate of 70.5%, while females had a relapse rate of 66.7%. Relapse by Age Group: 73.3% of patients below 30 years relapsed, compared to 62.9% in those aged 30 and above. Conclusions: The study found a high relapse rate of 68.8% among bipolar disorder patients. Treatment adherence and effective management of psychopathology are crucial for preventing relapse. The study highlights the importance of focusing on medication adherence and psychoeducation. Further research is needed to explore mental health care and relapse prevention in low-income countries to improve outcomes for bipolar disorder patients.