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[Differences between unipolar and bipolar affective disorders. Review and results from a clinical population]
H Spiessl1, B Hübner-Liebermann, C Cording
1Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität am Bezirksklinikum Regensburg, Germany. hermann.spiessl@bkr-regensburg.de
Objective:
On account of the different therapeutic options in mood disorders, differences between unipolar and bipolar disorders are described by reviewing the literature and evaluating data of a psychiatric basic documentation system (DGPPN-BADO).
Methods:
Based upon a sample of 18 846 psychiatric in-patients of the Bezirksklinikum Regensburg between 1989 and 1999, data of 2644 patients with unipolar depression (UD) and bipolar affective disorders (BAS) were analysed and compared with findings from previous studies.
Results:
77,8 % suffer from unipolar depression, 22,2 % from bipolar affective disorders. Patients with BAS fall ill 10 years earlier than patients with UD, they have a 50 percent higher number of hospital stays and longer cumulative length of stay, and they are significantly more ill at admission. In both patient groups we found a mean duration of hospital stay of about 45 days and a clinical improvement of nearly 25 points in GAF. Patients with BAS attempt suicide more often and have comorbid alcoholism more frequently. At discharge they show greater deficits in their psychosocial capability (measured with GAF) than patients with UD do.
Conclusion:
Patients with BAS, which had to be hospitalised, have a more severe course of illness, but they can be treated equally as effective and efficient as patients with UD.