The Use of Handwriting Changes for the Follow-up of Patients with Bipolar Disorder

Nusret AYAZ , Osman CELBİS , Esra PORGALI ZAYMAN , Rıfat KARLIDAĞ , Bedirhan Sezer ÖNAR
2022 March - 59 (1)
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Highlights


Abstract

Introduction: Patients with bipolar disorder have motor skill deficiency
and cognitive dysfunction. It is suggested that these deficiencies are
related to the neurodevelopmental course of the disease. The aim of
this study was to examine whether or not there was a change in the
handwriting of patients with bipolar disorder in periods of mania and
remission.
Method: Two samples of handwriting and signature were taken from the
cases, one on admission before treatment and one just after discharge.
The first sample was taken in the period when the patients hospitalised
with manic episode before medications and the second sample was
taken in remission when the decision for discharge was made. The
handwriting changes betwen the manic episode and the remission
period were examined.
Results: In the examination of the handwriting between the two periods,
there was an increase in the size of the writing, pen pressure, the
length of words, the spaces between words, and missing and incorrect
punctuation marks in the manic episode. There were no differences
in any handwriting measure on function of the specific diagnosis or
the antipsychotic dose but tremor count was higher in patients using
antipsychotics (p<0.05). Most of the parameters showing a change were
found to be related to the Young Mania Rating Scale (YMRS) scores.
Conclusion: The results of this study determined severe changes in
the handwriting of patients with bipolar disorder in a period of mania.
Handwriting features can be used to screen patients for discharge and
can be used for prediction when a patient might switch into manic
episode. Also intake YMRS scores were found as the most important
feature that affect handwriting parameters in manic patients.