Skip to main content Accessibility help

Age of onset in bipolar affective disorder and misdiagnosis as schizophrenia

  • Peter R. Joyce (a1)


The age of onset in bipolar affective disorder was determined in 200 hospitalized patients. The mean age of their first affective syndrome was 28·3 years, and the mean age of first hospitalization was 30·8 years. However, the median age for first affective syndrome was 23 years (26 years for first hospitalization), and the most common age of onset was 15–19 years. Those patients with an early onset, especially if they were first hospitalized for mania, were most likely to have received a diagnosis of schizophrenia.


Corresponding author

1Address for correspondence: Dr Peter Joyce Department of Psychological Medicine, The Princess Margaret Hospital, Christchurch, New Zealand.


Hide All
Abrams, R. & Taylor, M. A. (1981). Importance of schizophrenic symptoms in the diagnosis of mania. American Journal of Psychiatry 318, 658661.
Ballenger, J. C., Reus, V. I. & Post, R. M. (1982). The ‘atypical’ clinical picture of adolescent mania. American Journal of Psychiatry 139, 602606.
Baron, M., Klotz, J., Mendlewicz, J. & Rainer, J. (1981). Multiple-threshold transmission of affective disorders. Archives of General Psychiatry 38, 7984.
Brockington, I. F., Wainwright, S. & Kendell, R. E. (1980). Manic patients with schizophrenic or paranoid symptoms. Psychological Medicine 10, 7383.
Carlson, G. A. & Strober, M. (1978). Manic-depressive illness in early adolescence. Journal of the American Academy of Child Psychiatry 17, 138153.
Carpenter, W. T. & Stephens, J. N. (1980). The diagnosis of mania. In Mania: An Evolving Concept (ed. Belmaker, R. H. and van Praag, H. M.), pp 724. MTP Press: Lancaster.
Dunner, D. L. & Rosenthal, N. E. (1979). Schizoaffective states. The Psychiatric Clinics of North America 2, 441448.
Edelstein, P., Schultz, J. R., Hirschowitz, J., Kanter, D. R. & Garver, D. L. (1981). Physostigmine and lithium response in schizophrenias. American Journal of Psychiatry 138, 10781081.
Kane, J., Struve, F. A., Weinhold, P. & Woerner, M. (1980). Strategy for the study of patients at high risk for tardive dyskinesia. American Journal of Psychiatry 137, 12651267.
Kraepelin, E. (1921). Manic-depressive Insanity and Paranoia. Livingstone: Edinburgh.
Leonhard, K., Korff, I. & Schulz, H. (1962). Temperament in families with monopolar and bipolar phasic psychoses. Psychiatria et Neurologica 143, 416.
Loranger, A. W. & Levine, P. M. (1978). Age at onset of bipolar affective illness. Archives of General Psychiatry 35, 13451348.
Petterson, U. (1977). Manic-depressive illness: a clinical, social and genetic study. Acta Psychiatrica Scandinavica Suppl. 269.
Pope, H. G. & Lipinski, J. F. (1978). Diagnosis in schizophrenia and manic-depressive illness: a reassessment of the specificity of ‘schizophrenic’ symptoms in the light of current research. Archives of General Psychiatry 35, 811828.
Pope, H. G., Lipinski, J. F., Cohen, B. M. & Axelrod, D. T. (1980). ‘Schizoaffective disorder’: an invalid diagnosis? A comparison of schizoaffective disorder, schizophrenia, and affective disorder. American Journal of Psychiatry 137, 921927.
Rosenbaum, K. M., Niven, R. G., Hanson, H. P. & Swanson, D. W. (1977). Tardive dyskinesia: relationship with primary affective disorder. Diseases of the Nervous System 38, 423426.
Roth, M. & Barnes, T. R. E. (1981). The classification of affective disorders: a synthesis of old and new concepts. Comprehensive Psychiatry 22, 5477.
Rush, M., Diamond, F. & Alpert, M. (1982). Depression as a risk factor in tardive dyskinesia. Biological Psychiatry 17, 387392.
Sachar, E. J. & Baron, M. (1979). The biology of affective disorders. Annual Review of Neuroscience 2, 505518.
Targum, S. D. (1983). Neuroendocrine dysfunction in schizophreniform disorder: Correlation with six-month clinical outcome. American Journal of Psychiatry 140, 309313.
Taylor, M. A. & Abrams, R. (1980). Reassessing the bipolar–unipolar dichotomy. Journal of Affective Disorders 2, 195217.
Winokur, G., Clayton, P. J. & Reich, T. (1969). Manic-depressive Illness. C. V Mosby: St Louis.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed