title: Phenomenology and outcome of subjects with early- and adult-onset psychotic mania.
abstract: OBJECTIVE
  This study examined clinical differences between subjects with early-onset and adult-onset psychotic mania.
  
  
  METHODS
  Subjects were from an epidemiologically derived, hospitalized sample who met criteria for definite bipolar disorder after 24 months of follow-up and whose index episode had been manic. Information collected regarding demographic characteristics, psychotic and depressive symptoms, childhood behavior problems and school functioning, substance/alcohol use disorders, and episode recurrence for two subgroups were compared: those whose illness first emerged before age 21 (early onset) (N=23) and those whose first episode occurred after age 30 (adult onset) (N=30).
  
  
  RESULTS
  A larger proportion of the early-onset subjects were male, had childhood behavior disorders, had substance abuse comorbidity, exhibited paranoia, and experienced complete episode remission less frequently during 24-month follow-up than the adult-onset subjects.
  
  
  CONCLUSIONS
  These data add to the body of evidence that has suggested that many subjects with early-onset psychotic mania have a more severe and developmentally complicated subtype of bipolar disorder.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, State University of New York at Stony Brook, 11794-8790, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Carlson
authors.forename: E J
authors.initials: EJ
authors.lastname: Bromet
authors.forename: S
authors.initials: S
authors.lastname: Sievers
mesh_terms: D000124:Achievement; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology