Nuzhat Nauman, Sajjad A Shami, Rizwan Taj.
Manic-Depressive (Bipolar) illness: A genetic-epidemiological study.
J Pak Inst Med Sci Jan ;15(1):866-71.

The present study is based on 454 diagnosed manic-depressive patients. The data was collected from the outpatient Department of Psychiatry, Pakistan Institute of Medical Sciences. Affected Males were more in number than females (male: female ratio 1.05:1) but the difference between the two sexes was not significant. There were 162 unmarried patients and 292 married patients. The mean age at diagnosis of unmarried female patients was 18.95±0.97 and that of unmarried male patients 19.26±0.42 years, but the difference was not significant. Among married patients, the mean age at diagnosis of female patients was 33.32±0.83 years. Married Male patients were inflicted slightly earlier than females (32.46±0.98 years). However, the difference in age at onset between the two sexes was not significant. The inbred marriages in this study were 54.84% (n=249), of which first cousin unions were 47.35% (n=215). The inbred marriages were significantly higher in number as compared to out bred couples (p < 0.01). There were 134 family members inheriting manic-depressive illness and 106 patients out of these were from inbred marriages. Low paid Government servants and laborers were most affected with manic depressive illness, and prevalence was more in the less educated class.

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