A Cross-sectional study on the Ability to Remember Mania Symptoms in Patients with Type I Bipolar Disorder 60 Months after Hospital Discharge

Objectives: Identifying the acute symptoms of manic episode remembered by the patients can help psychiatrists improve their ability to manage bipolar disorder. Given the importance of remembering symptoms, the aim of this study was to evaluate the ability of patients with type I bipolar disorder during the euthymic period to remember their previous mania symptoms after hospital discharge. Methods: Participants were 59 patients with type I bipolar disorder admitted to the hospitals of Hazrat-e-Rasool-e-Akram and Iran in 2012. They measured by using Structured Clinical Interview for DSM-IV axis I disorders (SCID-I) and Young Mania Rating Scale (YMRS) and their mania symptoms were recorded. Their demographic information were extracted from their medical records. Sixth months after discharge, they were evaluated again by using the Hamilton Depression Rating Scale (HDRS-17), SCID-I, YMRS, and Mini–Mental State Examination (MMSE) through  face-to-face interview. To assess the agreement on the symptoms during admission and 60 months after discharge, McNemar Test and Kappa coefficients were used. Results: The most common symptoms remembered by the patients were decreased need for sleep (91.2%), irritability (83.9%), excessive involvement in activities with a high likelihood of painful consequences (81.3%) and the least frequent remembered symptom was distractibility (17.6%). The highest positive predictive values were related to the symptoms of irritability (100%), more talkative (100%) and decreased need for sleep (96.3%), while the highest negative predictive value was related to elevated mood (87.5%). Conclusion: In management of patients with bipolar disorder, psychiatrists can trust the patients’ ability to remember the three mania symptoms including irritability, decreased need for sleep and talkativeness. Regarding the symptom of elevated mood in bipolar patients, negative response of patients can be trusted.