Early Screening for Risks of Bipolar Disorder at the Preclinical Stage

Bipolar disorder (BD) is characterized by a high rate of prevalence in the general population varying from 0.6% to 5.84% (Yildiz 2015). BD is one of the leading causes of disability and mortality from suicide and comorbid diseases (Johnson et al. 2017). Individual symptoms of the disease in the form of cyclothymia-like mood fluctuations can be detected in adolescence and have potential for predicting risk for BD (Tijssen et al. 2010). The key issue here is untimely diagnosis of BD (Mosolov et al. 2014, Bardenshteyn et al. 2016). Early screening for risks of bipolar disorder at the preclinical stage.

The study involved 137 students aged from 18 to 20 years (mean age 18.93±0.09). The clinical-psychopathological method as well as the screening method of research were used: the Mini-International Neuropsychiatric Interview (M.I.N.I.), (Sheehan et al. 1998), the Hamilton Depression Rating Scale (HDRS 1960), the Mood Disorder Questionnaire (MDQ) (Hirschfeld 2000). The statistical data processing included descriptive statistical methods (p<0.05).

Clinical diagnostics of the responders using ICD-10 (WHO, 1992, Chapter V [F00-F99]) excluded the diagnosis of bipolar disorder. The MDQ screening method revealed a statistically significant excess of the average values for hypomania throughout the sample (M±m: 6.46±0.44; p<0.05). The total score of 64 interviewees (46.7%; 95% CI: 38.1-55.3) exceeded the threshold value (≥7). 68 responders (49.6%; 95% CI 41.0-55.3) showed one-stage manifestation of certain signs of mood rise. 72 interviewees (52.6%; 95% CI 43.9-58.3) reported absence of mood rise, associated with conflict behaviour, family problems etc. According to the HDRS scale, 45 responders (32.85%; 95% CI: 24.14-40.95) showed signs of mild depression (M±m: 6.51±0.39; p<0.05). Also, a group of responders (18.2%; 95% CI: 11.78-24.72) manifested exceeding indicators both for hypomania and depression.

According to the MDQ scale, 46.7% of the responders showed threshold values exceeding; with the one-stage manifestation of hypomania signs in 49.6% of the respondents. 32.85% of the responders showed signs of mild depression (the HAMD scale). 18.2% of the interviewees exceeded threshold values for both hypomania and depression. The discovered cyclothymia-like conditions at the preclinical stage have potential for predicting risk for their transformation to bipolar disorder which directs further outpatient clinical and dynamic observation.