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Birth-cohort and dual diagnosis effects on age-at-onset in Brazilian patients with bipolar I disorder

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da Silva Magalhães PV, Gomes FA, Kunz M, Kapczinski F. Birth-cohort and dual diagnosis effects on age-at-onset in Brazilian patients with bipolar I disorder. Objective: 

Substance use disorders and birth-cohort have been associated with an earlier onset in bipolar disorder (BD). This study aimed at evaluating the inter-relations of these factors in age-at-onset in bipolar illness. Method: 

Two-hundred and thirty patients with bipolar I disorder were cross-sectionally evaluated. Patients were categorized into four age groups for analysis. Lifetime comorbidity and age-at-onset were derived from the Structured Clinical Interview for DSM-IV. Results: 

There was a strong linear association between age group and age-at-onset. Lifetime alcohol and drug use disorders were also associated with age-at-onset. Illicit drug and alcohol use disorders and age group remained significant in the multivariate model. No interactions appeared. Conclusion: 

Both age group and dual diagnoses had strong and independent impacts on age-at-onset in out-patients with BD. Substance abuse may be partly accountable for earlier symptom onset, but other features of BD in younger generations are still in need to be accounted for.
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Keywords: age-at-onset; bipolar disorder; birth-cohorts; cohort effect; substance use disorders

Document Type: Research Article

Affiliations: 1: Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil 2: Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

Publication date: 2009-12-01

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