Unipolar mania: a particular aspect of Bipolar Disorder in Tunisia
Badii AMAMOU 1*, Wafa CHEBBI 1, Myriam ALLEGUE 1, Ahmed MHALLA 1, Ferid ZAAFRANE 1, Gaha LOTFI 1
Department of Psychiatry, Fattouma Bourguiba Hospital, Monastir, Tunisia
Received: April 10, 2017; Revised: May 10, 2017; Accepted: May 11, 2017; Published online: May 11, 2017.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Unipolar mania is a clinical reality in our daily practice. Many authors suggest that bipolar patients can only have manic episodes without depressions. These findings lead us to explore more this particularity.
It is a retrospective, descriptive and comparative study including 173 patients, followed for bipolar disorder type I, according to DSM5 criteria, during the period between January 2008 and December 2015. Two groups were identified. The first one was composed of 98 patients who only presented manic episodes. The second group contained the rest of the sample. Unipolar mania was defined as the presence of three or more manic states without a depressive episode during the period of the study.
One hundred seventy three patients were included in the study. The average age was 43 years old. The first episode was manic in 129 patients (74,6%). The dominant polarity was manic in 90.8% of the cases. Seasonal characteristic and psychotic symptoms were observed in respectively 11% and 53,2% of the sample. 2.3% of patients had rapid cycling evolution. The unipolar manic profile accounted for 56,6% of the population. This result is equivalent to an annual incidence of 8%. Comparing the two groups, we did not find a significant difference concerning the sociodemographic and clinical variables except for the number of suicide attempts (p=0,014).
In spite of its limits, our study shows that unipolar mania is a clinical evidence. So, more studies should be conducted in order to understand its nosological and psychopathological foundations.
Keywords: Unipolar mania, bipolar disorder, recurrent mania