Abstract
Objective: The aims of this study were to analyze the sense of identity in young adult patients with bipolar disorder and to compare and define the differences of bipolar patients with that of controls, including anxiety disorder patients and healthy subjects. Secondary aim was to investigate whether identity confusion (IC) is associated with clinical features of bipolar disorder (BD) or not.

Methods: In this study 50 patients in remission, aged between 18 and 65 years, diagnosed with bipolar disorder according to DSM-IV criteria, and age at onset of disease was 18 and over, were assessed. The group of anxiety disorder patients included 50 cases with Panic Disorder or Generalized Anxiety Disorder according to DSM-IV criteria, between the ages of 18-25, and the age of onset of illness was 18 and over. The healthy control group consisted of 50 individuals between 18-25 years old, with no psychiatric symptoms and treatment and with no history of application for treatment.

Results: The mean scores of Self Identity Assessment Form (SIAF) for both BD, (85.7±28.3) and anxiety disorder (74.5±24.1) were higher than healthy control group (56.6±23.5) (p<0.001, F=16.650). In patients with bipolar disorder having IC was associated with lower rate of being married (p=0.05), higher rate of a history of childhood attention deficit hyperactivity disorder (ADHD) (p=0.042) and allergic disease (p=0.038), having depression as the first episode (p=0.007), worse academic and social functioning (p=0.043 and p=0.009), greater rate of hospitalization (p=0.031), and earlier age at onset of treatment (p=0.05). Patients with IC also scored higher cyclothymic and irritable temperament scores (p=0.013 and p=0.008) and revealed higher rate of insecure attachments (p=0.05).

Conclusion: Young adult bipolar patients should be evaluated in terms of identity formation processes and the relation between mood disorder and the IC should not be overlooked.

Key words: Identity confusion, bipolar disorder, attachment, temperament