الفهرس 
List of all mood stabilizers that are recommended as per the condition of the patient.Only 14 pages are availabe for public view
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Abstract
Bipolar disorder is one of the leading causes of worldwide disability and morbidity. It has been frequently associated with serious medical and psychiatric comorbidity, early mortality, high levels of functional disability and compromised quality of life. It can be further subdivided into bipolar disorder I (BD I) and bipolar disorder II (BD II).
The etiopathogenesis of BD is multi-faceted with genetic, environmental and psychosocial factors playing a role. The diagnosis and management of BD are purely on empirical grounds as we lack confirmed biomarkers for this condition.
Finding a biological biomarker can have multiple potential applications in improving the diagnostic accuracy of the clinical process and may have a role for primary prevention in vulnerable individuals and identification of illness relapse.
Several studies have pointed to neurotrophic factors dysfunction to play a pivotal role in the neurobiology of the disorder. In this regard, brain-derived neurotrophic factor (BDNF) has been the most studied neurotrophic factor in BD. While Neurotrophine4/5(NT4/5) didn’t gain this attention in BD.
So this study aimed to investigate whether there is a reliable relation which could serve as a biomarker between bipolar patients and healthy controls by finding out the levels of NT4/5 in cases of bipolar disorder in manic episodes and also during remission. Comparing NT4/5 level between cases of bipolar disorder and control group. Searching for correlation between NT4/5 level and sociodemographic data and other clinical parameters.
To achieve the answer of these aims: a case control study with a sample of 30 bipolar patients from inpatient and outpatient clinic of Benha Psychiatric Hospital fulfilling the inclusion and exclusion criteria was performed. A compatible control group consisting of 30 healthy individuals who accepted and gave consent to participate in the research were also included.
All participants were subjected to semi structured interview, Structured Clinical Interview for DSM disorders (SCID I), Young Mania Rating scale and plasma level of NT4/5.
The study concluded some important relations and correlations as NT4/5 level showed lower significant levels when comparing bipolar manic patients either mild, moderate and severe with control group (p<0.001) for all.
In this study, a correlation between NT4/5 level and some studied parameters in bipolar patients such as sociodemographic data and other clinical data of bipolar disorder were assessed. Urban residency was significantly associated with lower NT 4/5 level when compared to rural residency (p <0.009). Otherwise, no significant differences were found regarding NT 4/5 level with sociodemographic data in studied cases. Also lower NT 4/5 level was significantly associated with those hospitalized patients (p<0.001). Otherwise, no significant differences were found regarding NT 4/5 level with clinical data of studied group.
Logistic regression analysis was conducted for prediction of bipolar disorder susceptibility using age, gender, marital status, residence, education, smoking, and NT 4/5 level as confounders. Higher educational level, smoking and lower NT 4/5 were associated with risk of bipolar disorder occurrence in univariable analysis. However, in multivariable analysis, only smoking and lower NT 4/5 were suggested to be independent risk predictor for bipolar disorder development and higher NT 4/5 was suggested to be independent predictor for remission of bipolar disorder.
Regarding severity: this study concluded that lower NT 4/5 and urban residency were associated with higher severity of bipolar disorder.
Although the researches on the importance of NT4/5 in affective disorders are rather at the beginning, an increasing number of evidence is supporting the involvement of NT4/5 in the pathogenic processes of this psychiatric disorder. Still, the studies covering this topic in their early days and the results that are trying to understand if there is a major role of NT4/5 in affective disorders are not consistent enough to draw definitive conclusions and establish with certainty where the place of NT4/5 in the affective disorders pathology is. In this research a small sample size of patients included and so may not have been statistically powered to find significant relation. So further studies with larger study groups are recommended to replicate, extend the current study findings and to achieve more adequate power to test the hypothesis and so that some insignificant correlations may prove to be significب.