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Master Thesis

Trouble bipolaire à début précoce : stadifier pour mieux traiter ?

Abstract : Bipolar disorder is a chronic, frequent psychiatric disease, which represents a public-health issue, with comorbid conditions and psycho social impact. To date, we consider different subtype of bipolar disorder (for example type 1 and 2). Even with these distinctions, the clinical heterogeneity of the disease remains, and our diagnosis methods are sometimes unprecise. In this research, we will see how age at onset can be a promising clinical data, to reduce these disparities. Hence, we can find specific clinical features for patients who declare a bipolar disorder at an early age (21 years in the literature), and a certain homogeneity within this subgroup. For example, there are more family histories of bipolar and affective disorder, more severity and more comorbidities (psychiatric and medical). Otherwise, we found that medical care is most of the time delayed for these patients, even if they declare earlier the disorder, with an important issue of misdiagnosis in the early adulthood. To date, CIM 11 and other clinical classifications we use to support our therapeutic action are categorial, and do not take on consideration the evolution and eventually the progressive decline over time. We explored how staging system applied specifically to bipolar disorder, and more especially to patients with an early age of onset, can be useful and prevent this limit. It is a model where the disorder can be declined in different stages, from a prodromal to a severe form, with chronicity and treatment resistance. These stages are defined according to many clinical markers, and neurobiological data. The use of staging could also be extended for all patients suffering from bipolar disorder, independently of their age of onset.
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https://dumas.ccsd.cnrs.fr/dumas-03368534
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Submitted on : Wednesday, October 6, 2021 - 6:33:49 PM
Last modification on : Wednesday, October 27, 2021 - 3:22:53 AM

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  • HAL Id : dumas-03368534, version 1

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Claire Elkael. Trouble bipolaire à début précoce : stadifier pour mieux traiter ?. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03368534⟩

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