Bipolar Disorder: Analysis of Frequency and Structure of Affective Phases “with Mixed Features” in the Focus of Prognosis

Background : despite numerous scientific studies, the topic of affective-mixed states in individuals diagnosed with bipolar disorder (BD) remains unexplored to a full extent due to difficulties in diagnosis, lower referral rates for medical advice, compared to depressive episodes, difficulties in developing correct therapeutic tactics and prognosis. The aim was to study the frequency of occurrence and structure of affective-mixed episodes in patients diagnosed with bipolar disorder. Patients and Methods: a total of 165 patients who underwent inpatient treatment for the first time at the Department for the Study of Endogenous Mental Disorders and Affective States of Mental Health Research Centre in the period from 2013 to 2023 were examined using clinical, psychopathological and statistical methods. All patients included in the study had a clinically confirmed diagnosis of bipolar disorder. Results : based on the affective characteristics, four groups of affective phases were distinguished: manic with mixed features, purely manic, depressive with mixed manifestations, and depressive without mixed features. The frequency rates of episodes with mixed features varied significantly from compared types of affective disorders. Patients with affective-mixed episodes were characterized by an early age of onset, a younger age at first hospitalization, frequent hospitalizations, and a high suicidal risk compared with patients without mixed features. Conclusion : the analysis made allow us to deepen our understanding of the BD course, clinical characteristics, and to formulate a therapeutic strategy for this patient population. The results obtained suggest the formation of a trajectory for future research in the field of bipolar disorder, including the development of an accurate definition of characteristics in patients with affective-mixed phases in bipolar disorder.