Life events and onset of mania in patients with bipolar 1 disorder admitted to Butabika hospital.

Abstract

INTRODUCTION: Mania accounts for 27.8% of all admissions in Butabika Hospital, and 22% of all patients presenting to Mulago hospital causality department for psychiatric problems. Whereas the association between life events and depression has been well established by a number of authors, studies on the association between life events and mania are limited. In fact no such study has yet been undertaken in the Ugandan cultural setting and Africa in general, despite the high prevalence of mania in our psychiatric units. OBJECTIVE: The objective of this study was to describe the prevalence and nature of life events preceding the onset of mania in patients admitted in Butabika hospital and compares this to that among a control group of patients attending the general out-patient clinic in the same hospital. STUDY DESIGN: A Case control study design with both descriptive and analytical methods was used. METHODOLOGY: Fifty three patients admitted with mania in Butabika hospital and 53 controls from the general out-patient clinic in the same hospital, matched for age and sex were screened for evidence of life events using the social readjustment rating scale in a corresponding four months period preceding admission of the patient with mania. RESULTS: There was no difference in the numbers of patients with mania who reported at least one event (66.0%) when compared to the control group (64.2%) (p=0.84). However, the patients with mania reported a significantly higher mean number of independent life events when compared to the control group, (p=0.01). A Significant increase in work related events and positive family events among the patients mania was also noted (p=0.04 & 0.02 respectively). CONCLUSION: The findings of this study are similar to those reported by other studies of the school of thought that an increase in life events is associated with the onset of mania. These results have important implications of the practice of psychiatry in Uganda and Africa in general as it shows the need to diversify the range of therapeutic services offered to our patients, to emphasize the role of psychotherapy, counseling and other social and occupational preventive and rehabilitation services.