title: Factors related to hospitalization in elderly manic patients with early and late-onset bipolar disorder.
abstract: OBJECTIVE
  To identify factors contributing to relapse and hospitalization in elderly patients with bipolar disorder.
  
  
  METHODS
  Retrospective chart review surveyed consecutive patients over age 65 admitted to the Johns Hopkins Hospital for a manic episode over a five year period (n=73). Factors precipitating index admission were compared in patients with early-onset bipolar disorder (<or=age 45, n=38) and late-onset bipolar disorder (>age 45, n=35).
  
  
  RESULTS
  The distribution of ages of onset of bipolar disorder was most consistent with a bimodal pattern with a cut-point at age 45. Early-onset patients were more likely to have been aggressive and threatening prior to admission (p=0.014) compared to late-onset patients and were more likely to have been brought to the emergency room on emergency petition for evaluation (p=0.028). Early-onset patients were also more likely to have been non-adherent with prescribed psychiatric medication (p=0.032).
  
  
  CONCLUSIONS
  Relapse and rehospitalization were common among elderly manic patients with early-onset and late-onset bipolar disorder. Strategies which improve medication adherence are needed to help prevent recurring hospitalization.
authors.affiliation: The Johns Hopkins University School of Medicine, Baltimore, MD 21287-7279, USA. slehman@jhmi.edu
authors.forename: Susan W
authors.initials: SW
authors.lastname: Lehmann
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology*; D003134:Commitment of Persons with Psychiatric Disorders; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D012008:Recurrence; D012189:Retrospective Studies