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Bipolar disorder in the elderly: a cohort study comparing older and younger patients

Nivoli, Alessandra M. A. and Murru, Andrea and Pacchiarotti, Isabella and Valenti, Marc and Rosa, Adriane R. and Hidalgo Mazzei, Diego and Virdis, V. and Strejilevich, Sergio and Vieta, Eduard and Colom, Francesc (2014) Bipolar disorder in the elderly: a cohort study comparing older and younger patients. Acta Psychiatrica Scandinavica, Vol. 130 (5), p. 364-373. ISSN 0001-690X. eISSN 1600-0447. Article.

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DOI: 10.1111/acps.12272

Abstract

Objective: The purpose of this study was to analyze differences in clinical and socio-demographic characteristics between older and younger bipolar outpatients paying special attention to depressive symptoms in a large, naturalistic cohort.
Method: Five hundred and ninety-three DSM-IV-TR bipolar outpatients were enrolled. Clinical characteristics were assessed according to DSM-IV-TR (SCID-I). Subjects were categorized into two groups according to current age (older OBD: age > 65 years; younger-YBD: age < 65 years).
Results: About 80% of patients were younger (N = 470), and a fifth were older (N = 123), with a mean age of 77.30 years in OBD. Older patients were more likely to be married, not qualified, bipolar II, with depressive polarity of first episode, higher age at illness onset, higher age at first hospitalization. They were more likely to present with depressive predominant polarity, with lifetime history of catatonic, psychotic and melancholic features, age at illness onset >40 years, as well as suffering from more medical comorbidities when compared to younger bipolars.
Conclusion: The clinical presentation of bipolar disorder in late life would be defined more frequently by melancholic depressive features and a predominantly depressive polarity. These results suggest that treatment strategies for elderly bipolar patients should focus in the prevention of depressive episodes.

Item Type:Article
ID Code:10275
Status:Published
Refereed:Yes
Uncontrolled Keywords:Bipolar disorder, elderly, predominant polarity, melancholic features
Subjects:Area 06 - Scienze mediche > MED/25 Psichiatria
Divisions:002 Altri enti e centri di ricerca del Nord Sardegna > Azienda ASL1, Sassari > Ospedale civile SS. Annunziata
001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Biomediche
Publisher:Blackwell / Wiley
ISSN:0001-690X
eISSN:1600-0447
Deposited On:07 Nov 2014 12:04

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