Several characteristics can be found in bipolar disorder according to the polarity of the first episode. This may affect the clinical course of the illness.

The current study explored the relationship between the polarity of the first episode and the sociodemographic characteristics of patients and clinical implications.

This was a retrospective and descriptive study. It involved 49 patients with the diagnosis of bipolar disorder I (DSM-IV) who were hospitalized in the department of Psychiatry “C” in Sfax University Hospital (Tunisia), between January 2010 and March 2011. These patients were divided into two groups according to the polarity of the first episode: those with depressive polarity (D) and those with manic polarity (M).

All the patients were male. Group (M) consisted of 33 patients and group (D) of 16 patients. The onset age of bipolar disorder, the origin of patients, their marital status and their socio economic level did not vary significantly depending on the polarity of the first episode. However, the level of education was greater and the irregular works was more frequent, significantly, in group (D) (p respectively: 0, 03 and 0,01). The depressive first episode was correlated with a depressive dominant polarity (p = 0,007) in the course of bipolar illness, bad quality of free intervals (p = 0,005) and more suicide attempts (p = 0,003).

This study indicates that first episode depressive polarity seems to have a relatively poor prognosis with a negative psychosocial impact.