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The impact of age at onset of bipolar I disorder on functioning and clinical presentation

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Biffin F, Tahtalian S, Filia K, Fitzgerald PB, de Castella AR, Filia S, Berk M, Dodd S, Callaly P, Berk L, Kelin K, Smith M, Montgomery W, Kulkarni J. The impact of age at onset of bipolar I disorder on functioning and clinical presentation. Objectives:

Recent studies have proposed the existence of three distinct subgroups of bipolar 1 disorder based on age at onset (AAO). The present study aims to investigate potential clinical and functional differences between these subgroups in an Australian sample. Methods:

Participants (n = 239) were enrolled in the Bipolar Comprehensive Outcomes Study (BCOS), a 2-year longitudinal, observational, cross-sectional study. Assessment measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD21), Clinical Global Impressions Scale (CGI-BP), SF-36, SLICE/Life Scale, and the EuroQol (EQ-5D). Participants were also asked about their age at the first major affective episode. Results:

Three AAO groups were compared: early (AAO < 20, mean = 15.5 ± 2.72; 44.4% of the participants); intermediate (AAO 20–39, mean = 26.1 ± 4.8; 48.14% of the participants) and late (AAO > 40, mean = 50.6 ± 9.04; 7.4% of the participants). Higher rates of depression, suicidal ideation and binge drinking were reported by the early AAO group. This group also reported poorer quality of life in a number of areas. The early AAO group had a predominant depressive initial polarity and the intermediate group had a manic predominance. Conclusion:

Early AAO is associated with an adverse outcome.

Keywords: bipolar disorder; depression; mania; psychosis

Document Type: Research Article


Affiliations: 1: Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia 2: Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia 3: Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia 4: School of Social Sciences, University of Western Sydney, Penrith South Dc, Australia

Publication date: 2009-08-01

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