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Age at onset in 3014 Sardinian bipolar and major depressive disorder patients

Authors

  • L. Tondo,

    1. Department of Psychiatry, Harvard Medical School and International Consortium for Psychotic and Mood Disorders Research, McLean Division of Massachusetts General Hospital, Boston, MA, USA
    2. Department of Psychology, University of Cagliari, Sardinia, Italy
    3. Lucio Bini Mood Disorder Research Center, Cagliari, Sardinia, Italy
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  • B. Lepri,

    1. Lucio Bini Mood Disorder Research Center, Cagliari, Sardinia, Italy
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  • N. Cruz,

    1. Department of Psychiatry, Harvard Medical School and International Consortium for Psychotic and Mood Disorders Research, McLean Division of Massachusetts General Hospital, Boston, MA, USA
    2. Department of Psychiatry, University of Barcelona, Spain
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  • R. J. Baldessarini

    1. Department of Psychiatry, Harvard Medical School and International Consortium for Psychotic and Mood Disorders Research, McLean Division of Massachusetts General Hospital, Boston, MA, USA
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Ross Baldessarini, Mailman Research Center, McLean Hospital, 115 Mill Street, Belmont, MA, USA.
E-mail: rjb@mclean.org

Abstract

Tondo L, Lepri B, Cruz N, Baldessarini RJ. Age at onset in 3014 Sardinian bipolar and major depressive disorder patients.

Objective:  To test if onset age in major affective illnesses is younger in bipolar disorder (BPD) than unipolar-major depressive disorder (UP-MDD), and is a useful measure.

Method:  We evaluated onset-age for DSM-IV-TR major illnesses in 3014 adults (18.5% BP-I, 12.5% BP-II, 69.0% UP-MDD; 64% women) at a mood-disorders center.

Results:  Median and interquartile range (IQR) onset-age ranked: BP-I = 24 (19–32) < BP-II = 29 (20–40) < UP-MDD = 32 (23–47) years (P < 0.0001), and has remained stable since the 1970s. In BP-I patients, onset was latest for hypomania, and depression presented earlier than in BP-II or UP-MDD cases. Factors associated with younger onset included: i) being unmarried, ii) more education, iii) BPD-diagnosis, iv) family-history, v) being employed, vi) ever-suicidal, vii) substance-abuse and viii) ever-hospitalized. Onset-age distinguished BP-I from UP-MDD depressive onsets with weak sensitivity and specificity.

Conclusion:  Onset age was younger among BPD than MDD patients, and very early onset may distinguish BPD vs. UP-MDD with depressive-onset.

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