FEATURES OF THE DEVELOPMENT OF MANIC AND MIXED EPISODES IN PATIENTS WITH BIPOLAR AFFECTIVE DISORDER UNDER THE INFLUENCE OF CANNABINOIDS

FEATURES OF THE DEVELOPMENT OF MANIC AND MIXED EPISODES IN PATIENTS WITH BIPOLAR AFFECTIVE DISORDER UNDER THE INFLUENCE OF CANNABINOIDS Ochilov Ulug’bek Usmanovich [email protected] DSc, Associate Professor of the department of psychiatry and narcology, Samarkand State Medical University, Uzbekistan, Samarkand city, Amir Temur street 18, Tel: +998 66 2330841 E-mail: [email protected]. Numonov Orifjon Marat o’g’li [email protected] Clinical Resident, Psychiatry and Narcology Course, Samarkand State Medical University, Uzbekistan, Samarkand city, Amir Temur street 18, Tel: +998 66 2330841 E-mail: [email protected]. Axmedova Sadoqat Abduraxmonovna [email protected] Clinical Resident, Psychiatry and Narcology Course, Samarkand State Medical University, Uzbekistan, Samarkand city, Amir Temur street 18, Tel: +998 66 2330841 E-mail: [email protected]. https://doi.org/10.5281/zenodo.18236563 ANNOTATION: Relevance. The use of cannabinoids significantly affects the course of bipolar affective disorder (BAD). In particular, the pathoplastic effect on the development of the first manic or mixed episode has been insufficiently studied in the scientific literature. Moreover, the lack of unified diagnostic criteria for mixed manic states creates challenges in clinical practice. Objective. The aim of the study was to identify the characteristics of the first manic or mixed episode in patients with bipolar affective disorder under the influence of cannabinoids and to investigate potential predictors of euthymia formation. Materials and Methods. The study included 47 patients diagnosed with bipolar affective disorder (manic or mixed episode) during their first hospitalization. Patients were divided into two groups: 1) 26 patients (17 men, 9 women) with cannabinoid dependence; 2) 21 patients (16 men, 5 women) in the control group who did not use cannabinoids. Syndromic, symptomatic, and functional recovery, as well as hospitalization duration and treatment adherence, were evaluated. Results. Among cannabinoid users, manic episodes with psychotic symptoms were more common (45%), while mixed episodes predominantly manifested with anxiety symptoms (34%). In the control group, 92% of patients achieved symptomatic recovery, compared to only 37% in the cannabinoid-dependent group. Cannabinoid users had longer hospital stays and lower adherence to treatment. Additionally, they more frequently experienced manic syndrome with psychotic features. Conclusion. Cannabinoid use in patients with bipolar affective disorder contributes to frequent recurrence of episodes, poor treatment adherence, and reduced functional performance during euthymia. Psychotic symptoms are more prominent in the structure of manic syndrome, while mixed manic episodes often present as dysphoric mania. Analysis of the data allowed the identification of two clinical variants of bipolar affective disorder: the first variant is characterized by single or irregular, well-defined mixed manic episodes; the second variant features frequent recurrence of mixed manic episodes with minimal remission, associated with a less favorable prognosis. Keywords: bipolar affective disorder, cannabinoids, manic episode, mixed episode, pathoplastic effect, euthymia, psychotic symptoms.

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