Age-grouped differences in bipolar mania.
OBJECTIVE
This review of published studies compares scores on individual items of mania rating scales that systematically recorded symptom severity in persons diagnosed with bipolar disorder to identify age-grouped differences.


METHODS
An extensive literature search identified item scores from mania rating scales, with a particular emphasis on baseline Young Mania Rating Scale (YMRS) item scores in published double-blind, placebo-controlled studies of bipolar I manic disorder. These baseline YMRS item scores were assessed as a proportion of the total YMRS score and compared by age group. Additional YMRS item/total scores in subjects with bipolar spectrum disorders were added to expand the analysis.


RESULTS
Preadolescents with bipolar disorder had significantly higher YMRS item scores than adolescents on aggression, irritability, and motor activity. Young Mania Rating Scale baseline item scores relative to the YMRS total score revealed that adolescents diagnosed with bipolar I mania scored comparatively higher than did adults on YMRS aggression and irritability items, whereas adults with bipolar I manic disorder scored comparatively higher on the grandiosity and sexual interest items. Age-grouped findings from subjects diagnosed with bipolar I, II, and Not Otherwise Specified (NOS) disorders yielded similar age-grouped results.


CONCLUSIONS
In age-grouped YMRS item assessments of bipolar mania, anger dyscontrol was most prominent for youth, whereas disordered thought content was paramount for adults.
Departments of Psychiatry and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. dsafer@jhmi.edu
Daniel J
DJ
Safer
Julie
J
Magno Zito
Alan M
AM
Safer
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000374:Aggression / Q000187:drug effects / Q000523:psychology; D000786:Anger / Q000187:drug effects; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000068180:Aripiprazole; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002986:Clinical Trials as Topic; D015897:Comorbidity; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D007508:Irritable Mood / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D000077152:Olanzapine; D010879:Piperazines / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D015363:Quinolones / Q000627:therapeutic use; D012725:Sexual Behavior / Q000187:drug effects / Q000523:psychology; D013850:Thinking / Q000187:drug effects; D055815:Young Adult
D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D001569:Benzodiazepines; D000068180:Aripiprazole; D000077152:Olanzapine