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

Authors

  • Frances Biffin,

    Corresponding author
    1. Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
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  • Steven Tahtalian,

    1. Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
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  • Kate Filia,

    1. Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
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  • Paul B. Fitzgerald,

    1. Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
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  • Anthony R. De Castella,

    1. Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
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  • Sacha Filia,

    1. Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
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  • Michael Berk,

    1. Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia
    2. Orygen Research Centre, Parkville, Australia
    3. Mental Health Research Institute, Parkville, Australia
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  • Seetal Dodd,

    1. Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia
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  • Pam Callaly,

    1. Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia
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  • Lesley Berk,

    1. Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia
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  • Katarina Kelin,

    1. Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia
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  • Meg Smith,

    1. School of Social Sciences, University of Western Sydney, Penrith South Dc, Australia
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  • William Montgomery,

    1. Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia
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  • Jayashri Kulkarni

    1. Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia
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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.

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