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KMID : 1118520110080030214
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Psychiatry Investigation
2011 Volume.8 No. 3 p.214 ~ p.220
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Reduced Fertility and Fecundity among Patients with Bipolar I Disorder and Schizophrenia in Egypt
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Mansour Hader
Kandil Kareem
Wood Joel
Fathi Warda
Elassy Mai
Ibrahim Ibtihal
Salah Hala
Yassin Amal
Elsayed Hanan
Tobar Salwa
El-Boraie Hala
Eissa Ahmed
Elhadidy Mohamed
Ibrahim Nahed E.
El-Bahaei Wafaa
Nimgaonkar Vishwajit L.
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Abstract
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Objective: To evaluate reproduction among patients with bipolar I disorder (BP1) or schizophrenia (SZ) in Egypt.
Methods: BP1 patients (n=113) were compared with community based, demographically balanced controls (n=124) and SZ patients (n=79, DSM-IV). All participants were evaluated using structured interviews and corroborative data were obtained from relatives. Standard indices of procreation were included in multivariate analyses that incorporated key demographic variables.
Results: Control individuals were significantly more likely to have children than BP1 or SZ patients (controls 46.8%, BP1 15.9%, SZ 17.7%), but the BP1-SZ differences were non-significant. The average number of children for BP1 patients (0.37±0.9) and SZ patients (0.38±0.9) was significantly lower than for controls (1.04±1.48) (BP1 vs controls, p<0.001; SZ vs controls, p<0.001). The frequency of marriages among BP1 patients was nominally higher than the SZ group, but was significantly lower than controls (BP1: 31.9% SZ: 27.8% control: 57.3%). Even among married individuals, BP1 (but not SZ) patients were childless more often than controls (p=0.001). The marital fertility, i.e., the average number of children among patients with conjugal relationships for controls (1.8±1.57) was significantly higher than BP1 patients (1.14±1.31, p=0.02), but not significantly different from SZ patients (1.36±1.32, p=0.2).
Conclusion: Selected reproductive measures are significantly and substantially reduced among Egyptian BP1 patients. The reproductive indices are similar among BP1 and SZ patients, suggesting a role for general illness related variables. Regardless of the cause/s, the impairment constitutes important, under-investigated disability.
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KEYWORD
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Reproduction, Bipolar disorder, Schizophrenia, Fertility, Fecundity
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