An Overview of Indian Research in Bipolar Mood Disorder

By Rao, Prasad | Indian Journal of Psychiatry, September 2010 | Go to article overview

An Overview of Indian Research in Bipolar Mood Disorder


Rao, Prasad, Indian Journal of Psychiatry


Byline: Prasad. Rao

This review has been done after careful research of articles published in indian journal of psychiatry with the search words of manic depressive psychosis and bipolar mood disorder. Many articles in the following areas are included: 1) Etiology: genetic studies: 2) Etiology - neuro psychological impairment: 3) Adult bipolar disorder 4) Epidemological 5) Clinical picture - phenomenology: 6) Course of bipolar mood disorder: 7) Juvenile onset bipolar affective disorder 8) Secondary mania: 9) Clinical variables and mood disorders: 10) Disability: 11) Comorbidity: 12) Treatment: biological 13) Recent evidence: 14) Pharmacological evidence in special population. Though there seems to be significant contribution, there are still lot of areas which need careful intervention. The findings in various studies from the indian point of view are reviewed.

Introduction

In 1896, Kraeplin reported 'manic-depressive psychoses' as a circumscribed disease entity. Ever since, manic depressive psychosis, or the current term used nosologically as 'bipolar' mood disorder, has been studied in the Indian perspective. Though it seems like there is no orderliness in the research pursuit of understanding this disorder in the Indian context, one gets an impression that all aspects like nosology, clinical syndromes, course, pharmacological and in special populations as well, were attempted to be looked at from the Indian context. This review is an attempted peep into Indian context research.

A review of the studies on bipolar mood disorders (Manic Depressive Psychosis) over the last many decades, published in Indian Journal of Psychiatry, conveys the feeling that over the years, though many aspects have been studied, there is no consistency in reports across the country. Reviewing research would find case reports to studies and reviews. Representative studies have come from across the country and in a way present the diversity of various centers; it doesn't seem to come from one center alone. We attempt to collect all the studies published in this area by going through as many old issues of Indian Journal of Psychiatry as were available.

Etiology: Genetic studies

Dermatoglyphics as a diagnostic tool studied 100 normal, 60 manic depressive psychosis subjects, 30 unipolar subjects, 30 bipolar subjects at Chandigarh. [sup][1] Details of socio demographic, family h/o, and diagnosis based on ICD 8 1965 and DSM II 1968 were used. Finger and palm prints were studied as per standard guidelines. Interesting findings emerged. There were differences between unipolar and bipolar groups vis a vis normal groups in various measures. The significance found was - Patients with manic depressive psychosis and with positive family h/o had differed as a group with negative family h/o, making the authors to conclude that genetic factors do play a role in manic depressive psychosis.

Lithium response as [sup][2] a prophylactic agent in a 25-patient cohort

Among 25 patients with 1.4 years of optimum serum level of 0.6 M.EQ/L, precise and absence of positive h/o of psychiatric illness in first degree relatives of family members was seen. The patients were divided into two groups based on chart reviews in responders and non responders. Responders significantly had positive family h/o affective illness. Though this study had only a small sample, for the first time in Indian literature, it commented on the genetic aspects of pharmacological response.

Genomic imprinting in bipolar affective disorder was studied by R. Kumar et al . 2000 at Central Institute of Psychiatry (CIP), Ranchi; [sup][3] in the first episode, bipolar affective disorder was diagnosed according to DSM IV 1994 criteria and without any comorbidity. This is the first study in bipolar mood disorder in genomics. Out of 79 conservative cases with first degree, the results of this study did not establish a phenomenon of imprinting in non mendelian patterns of inheritance leading the authors to conclude that bipolar disorder is heterogeneous. …

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