title: [Clinical and evolutionary characteristics of bipolar disorder according to the polarity of the first episode].
abstract: BACKGROUND
  The polarity of the inaugural episode seems to determine the clinical and evolutionary profile of bipolar disorder.
  
  
  OBJECTIVE
  To study the clinical and evolutionary characteristics bipolar disorder according to the polarity of the first episode.
  
  
  METHODS
  We undertook a retrospective, descriptive and comparative study including all the patients reached of bipolar disorder I and II (DSM IV TR) who were hospitalized between January 1 2000 and December 31 2006. The minimal duration of follow-up was 4 years. Patients were divided into two groups according to the polarity of the first episode: maniac or hypomaniaque and depressive. The characteristics sociodemographic, clinical, evolutionary and therapeutic were raised and compared between the two groups.
  
  
  RESULTS
  The sample was composed of 38 patients (23 men and 15 women). The first episode was of polarity maniac in 57.89% of cases. This mode of beginning was related to a later polarity preferentially maniac, more often punctuated of characteristics psychotics with a sur representation of the addictives conduits and bipolar disorder of type I an episode index of depressive polarity was associated to more chronic evolution, marked by a stronger recurrence of episodes particularly depressive episodes, with a raised suicidal risk and a high representation of the bipolar disorder II.
  
  
  CONCLUSIONS
  The clinical and evolutionary profile of the bipolar disorder seems strongly related to the polarity of the first episode. The strategies of prevention must take account of the inaugural polarity.
authors.affiliation: Hôpital Razi, Manouba Tunise, Faculté de Médecine de Tunis, Université Tunis El Manar.
authors.forename: Nessrine
authors.initials: N
authors.lastname: Bram
authors.forename: Hend
authors.initials: H
authors.lastname: Elloumi
authors.forename: Haifa
authors.initials: H
authors.lastname: Zalila
authors.forename: Majda
authors.initials: M
authors.lastname: Cheour
authors.forename: Afif
authors.initials: A
authors.lastname: Boussetta
mesh_terms: D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult