bipolar disorder | Acta Medica Marisiensis

Introduction: Bipolar affective disorder is a chronic psychiatric illness characterized by alternating episodes of elevated and depressed mood. Its clinical presentation varies widely, requiring a nuanced diagnostic approach. Differentiating between type one and type two forms remains essential for appropriate treatment planning.
Presentation of case series: This case series describes three patients diagnosed with bipolar affective disorder, each presenting distinct clinical patterns. The first patient exhibited a classic manic episode with psychotic features, requiring inpatient stabilization and combination pharmacotherapy. The second case involved a depressive episode with a prior history of hypomania, consistent with bipolar type two. The third patient presented a mixed episode marked by agitation, emotional instability, and suicidal ideation. All cases included a family history of mood disorders, supporting genetic predisposition. Therapeutic interventions consisted of mood stabilizers, antipsychotics, and psychoeducation. Clinical evolution was favorable in patients with high adherence and social support.
Conclusions: Bipolar affective disorder presents with diverse and sometimes atypical symptoms. Early recognition and accurate subtype differentiation are crucial for effective management. Case-based observation highlights the importance of individualized treatment, psychosocial support, and long-term monitoring.

A Comparative Study of Affective Bipolar Disorder with Schizoaffective Disorder from a Longitudinal Perspective

Milin Miruna¹, Lăzărescu M², Racolţa Anca², Silvoşeanu C², Bredicean Cristina³

1 PhD Student, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
2 Timișoara Psychiatric Clinic, Timișoara, Romania
3 Department of Neurosciences, Victor Babes University of Medicine and Pharmacy, Timișoara, Romania

DOI: 10.2478/amma-2013-0051

Introduction: In the last years there is a great interest for the theory of the “psychotic continuum”, which accepts that there is a transition between schizophrenia and affective pathology, including bipolar disorder with psychotic interferences and the recently introduced diagnosis of schizoaffective disorder. There are few studies that analyze bipolar disorder with mood-incongruent psychosis. The purpose of this study was to observe the way in which the interference of mood-incongruent psychotic symptoms can influence the long term evolution of patients diagnosed with bipolar disorder and the similarities that exists between this type of pathology and schizoaffective disorder.
Material and methods: Sixty subjects were selected, who are now diagnosed with schizoaffective disorder and bipolar disorder, with and without psychotic features. All cases have at least 15 years of evolution since the first episode of psychosis and were analyzed in term of their age of onset and longitudinal evolution.
Results: The results showed that bipolar patients who had mood incongruent psychotic symptoms had an earlier age of onset and a higher rate of hospitalizations in their long term evolution compared to bipolar patients without psychotic features, which brings them closer to patients with schizoaffective disorder in term of their pattern of evolution.
Conclusions: This study has demonstrated that the interference of mood-incongruent psychosis with bipolar disorder determines a worse prognosis of this disease, very similar with the evolution of patients with schizoaffective disorder.