MedWire News: Bipolar I disorder patients who have an early age of onset have a worse outcome than those with a later age of onset, the results of an Australian study indicate.
It has been suggested that there are three distinct ages of onset for bipolar disorder, at average ages of 16.9 years, 26.9 years, and 46.2 years, which differ significantly in terms of clinical presentation and family history of affective disorders.
To determine the impact of the age-of-onset groups on clinical and functional outcomes, Frances Biffen, from the Alfred and Monash University in Melbourne, and colleagues studied 239 participants in the Bipolar Comprehensive Outcomes Study.
The patients were assessed using the Young Mania rating Scale, Hamilton Depression Rating Scale, Clinical Global Impressions Scale, Short Form-36, SLICE/Life Scale, and the EuroQol. They were also asked about their age at the first major effective episode.
Of the 162 patients included in the final analysis, 72 had an early age at onset (≤19 years), 78 had an intermediate age at onset (20–39 years), and 12 had a late age at onset (≥40 years). The average age at onset for the three groups was 15.5 years, 26.1 years, and 50.6 years, respectively.
Patients with an early age of onset had significantly more severe depressive symptoms and higher rates of suicidal ideation than other patients. Early onset patients also were also more likely to experience a depressive first episode than other patients, at 72.0% versus 55.5% for intermediate-onset patients.
The researchers report in the journal Acta Neuropsychiatrica that early onset patients had more frequent psychologic distress, and subsequent social and role disability than other patients, and were more dissatisfied with their lives. Interestingly, there were no significant differences in objective measures of quality of life.
The team writes: “The relationship of the age of onset of bipolar disorder with the course of illness and outcomes is significant. This has important implications for the early detection, intervention and overall treatment of the disorder.”
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