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

Published online by Cambridge University Press:  24 June 2014

Frances Biffin*
Affiliation:
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
Steven Tahtalian
Affiliation:
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
Kate Filia
Affiliation:
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
Paul B. Fitzgerald
Affiliation:
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
Anthony R. de Castella
Affiliation:
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
Sacha Filia
Affiliation:
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
Michael Berk
Affiliation:
Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia Orygen Research Centre, Parkville, Australia Mental Health Research Institute, Parkville, Australia
Seetal Dodd
Affiliation:
Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia
Pam Callaly
Affiliation:
Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia
Lesley Berk
Affiliation:
Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia
Katarina Kelin
Affiliation:
Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia
Meg Smith
Affiliation:
School of Social Sciences, University of Western Sydney, Penrith South Dc, Australia
William Montgomery
Affiliation:
Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia
Jayashri Kulkarni
Affiliation:
Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
*
Frances Biffin, First Floor, Old Baker Bldg, Baker Lane, The Alfred Hospital, Melbourne VIC 3004, Australia. Tel: +61 3 9076 6907; Fax: +61 3 9076 6556; E-mail: f.biffin@alfred.org.au

Abstract

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.

Type
Research Article
Copyright
Copyright © 2009 John Wiley & Sons A/S

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