Bayesian Joint Modeling on the Burden of Bipolar Symptoms and Time to Symptomatic Recovery of Bipolar Disordered Patients: The case of Jimma University Medical Center, Jimma, Ethiopia

Abstract

Background:- Bipolar disorder also known as manic-depressive disorder is a mental health problem that primarily affects mood. Symptoms of bipolar disorder are extreme irritability or agitation, a period of feeling empty,loss of interest in normal activities, sleep problems and etc. Symptomatic recovery is a dimensional measure that refers to improvement in the magnitude of symptoms. Even though it is better if studying the association between burden of symptoms and time to symptomatic recovery of bipolar disorder, there is no study done that show it till now. Objectives:-The objective of the study is to fit the joint model and examine the association between burden of symptoms and time to symptomatic recovery of bipolar disordered individuals. Methodology:-The retrospective data from all the admitted follow up of bipolar disorder patients, who have followed at least three visits from first, September,2018 to first January,2020 in Jimma University Medical Center is used in this study. The study follows two stage,first fitting separate survival and longitudinal models and Joint Model is fitted next. Results:-From the total of 257 bipolar disorders,about 116(45.1%) of them experienced event of recovery.The covariates time in month,age , the interaction between time in month and adolescent first onset of the disease,the interaction between time in month and event of relapse, the interaction between linear time in month and existence of other cofactors and the interaction of substance abuse and chewing khat are significantly affect the log-expected burden of bipolar symptoms.In survival sub-model the covariates;divorced ,event of relapse, mixed type of episodes are significantly affects the time to symptomatic recovery of individuals at 5% significance level Conclusions and Recommendations:- From the Joint model,there is a negative relationship between event of recovery and burden of bipolar symptoms at the baseline time.This indicates that at the beginning time since burden of bipolar symptoms is high the chance of symptomatic recovery is low. Then at the base time the psychiatrists and the concerned body should give special service for the patients.