Get access

Early age at onset of bipolar disorder is associated with more severe clinical features but delayed treatment seeking

Authors

  • Kirsi Suominen,

    1. Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki
    2. Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo
    Search for more papers by this author
  • Outi Mantere,

    1. Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki
    2. Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo
    Search for more papers by this author
  • Hanna Valtonen,

    1. Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki
    2. Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo
    Search for more papers by this author
  • Petri Arvilommi,

    1. Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki
    2. Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo
    Search for more papers by this author
  • Sami Leppämäki,

    1. Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki
    2. Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo
    3. Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
    Search for more papers by this author
  • Tiina Paunio,

    1. Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo
    2. Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
    Search for more papers by this author
  • Erkki Isometsä

    1. Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki
    2. Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
    Search for more papers by this author

  • The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

Kirsi Suominen, MD, PhD, Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland.
Fax: +358 9 4744 8478;
e-mail: kirsi.suominen@ktl.fi

Abstract

Objective:  Our aim was to obtain a comprehensive view of differences between bipolar disorder (BD) patients with onset at early versus adult age in a representative study cohort.

Methods:  In the Jorvi Bipolar Study (JoBS), 1,630 psychiatric in- and outpatients were systematically screened for BD using the Mood Disorder Questionnaire (MDQ). A total of 191 bipolar I and II patients with a current DSM-IV episode were interviewed to obtain information about age at onset of mood symptoms, clinical course, treatment, comorbidity, and functional status. The patients were classified as either early onset (<18 years) or adult onset.

Results:  One-third of subjects with BD (58/191, 30%) had early onset. This was associated with female gender, more lifetime psychotic symptoms, greater overall comorbidity, and a greater length of time from first episode to treatment.

Conclusions:  Although BD patients with early age at onset have more severe clinical features and illness course, the delays from first episode to treatment and to correct diagnosis are longer than for those with adult onset disorder. To reduce morbidity rates related to the most severe forms of BD, the recognition and diagnosis of BD during adolescence needs to be improved.

Get access to the full text of this article

Ancillary