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

  1. Frances Biffin1,*,
  2. Steven Tahtalian1,
  3. Kate Filia1,
  4. Paul B. Fitzgerald1,
  5. Anthony R. De Castella1,
  6. Sacha Filia1,
  7. Michael Berk2,5,6,
  8. Seetal Dodd2,
  9. Pam Callaly2,
  10. Lesley Berk2,
  11. Katarina Kelin3,
  12. Meg Smith4,
  13. William Montgomery3,
  14. Jayashri Kulkarni1

Article first published online: 17 AUG 2009

DOI: 10.1111/j.1601-5215.2009.00399.x

Issue

Acta Neuropsychiatrica

Acta Neuropsychiatrica

Volume 21, Issue 4, pages 191–196, August 2009

Additional Information

How to Cite

Biffin, F., Tahtalian, S., Filia, K., Fitzgerald, P. B., De Castella, A. R., Filia, S., Berk, M., Dodd, S., Callaly, P., Berk, L., Kelin, K., Smith, M., Montgomery, W. and Kulkarni, J. (2009), The impact of age at onset of bipolar I disorder on functioning and clinical presentation. Acta Neuropsychiatrica, 21: 191–196. doi: 10.1111/j.1601-5215.2009.00399.x

Author Information

  1. 1

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

  2. 2

    Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia

  3. 3

    Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia

  4. 4

    School of Social Sciences, University of Western Sydney, Penrith South Dc, Australia

  5. 5

    Orygen Research Centre, Parkville, Australia

  6. 6

    Mental Health Research Institute, Parkville, Australia

*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

Publication History

  1. Issue published online: 17 AUG 2009
  2. Article first published online: 17 AUG 2009

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Keywords:

  • bipolar disorder;
  • depression;
  • mania;
  • psychosis

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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