The Evaluation of Anxiety, Depression and Global Assessment of Functioning in Bipolar Patients at Manic and Mixed Episodes

Document Type: Original Article


1 Assistant Professor of Psychiatry, Afzalipour School of Medicine & Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.

2 Associate Professor of Psychiatry, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

3 Psychiatrist, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.

4 Specialist in Social Medicine, Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.


Background and Aims: This research is carried out with the aim of comparing anxiety, depression and global assessment of functioning between two groups of bipolar patients at mixed and manic episodes. Methods: Using an analytical cross-sectional approach, a sample of 94 patients with mean age of 32 years old (Standard Deviation: 11.3), who had been categorically diagnosed with bipolar disorder using DSM-IV criteria and admitted in Shahid Beheshti Mental Hospital of Kerman /Iran from autumn 2007 to summer 2008 were analysed. These patients were grouped under two categories of Manic episode (n=48) and Mixed episode (n=46). Hamilton’s Rating Scale for Depression (HRSD) and Hamilton’s Anxiety Rating scale (HARS) tests were performed. Patients’ functionality were rated during their illness and for the period of 6 months before their infirmity using “Global Assessment of Functioning” (GAF) scoring system. Multiple logistic regression analysis, t-test, ANCOVA, MANOVA and Pearson Correlation coefficient were used for data analysis. Results: Mean Hamilton’s depression scores in mixed and mania groups had a significant difference (P<0.001) and mean Hamilton’s Anxiety score of Mania group was significantly higher than that of mixed group. Patients’ functionality rate at the time of admission was reduced considerably comparing to the 6 months prior to the admission in both groups but at admission the functionality of the tow groups did not have a significant difference. Conclusion: Both anxiety and depression in bipolar patients at mixed episode are higher than those in Patients at mania episode. Although the functionality of both of these groups reduces at the time of episode, there is no significant difference between these tow groups in their functionality rate.