Age of onset and the prospectively observed course of illness in bipolar disorder.
BACKGROUND
To test the validity of age-of-onset grouping in bipolar disorder through the use of prospectively observed time in mood episodes.


METHODS
Age-of-onset ranges from prior admixture analyses were used to divide 427 individuals with bipolar I or bipolar II disorders into early-, middle- and late- onset groups. These were compared by the proportions of weeks depressed and manic or hypomanic during a mean (SD) prospective follow-up of 17.4 (8.4) years.


RESULTS
As predicted, the group with the earliest onsets reported at intake more previous episodes, suicide attempts and panic attacks. An early age of onset, but not current age, was predictive of significantly more time in depressive episodes during follow-up but was not predictive of time in manic or hypomanic episodes.


CONCLUSIONS
This was a naturalistic study with no control of treatment so variability in treatment may have obscured relationships between predictors and outcomes. Age of onset was retrospectively determined and subject to inaccuracies in recall.


CONCLUSIONS
An early age of onset conveys, to a modest degree, a poorer prognosis as expressed in more depressive morbidity.
Department of Psychiatry, University of Iowa, Carver College of Medicine, 500 Newton Road, Iowa City, IA 52231-1190, United States. william-coryell@uiowa.edu
William
W
Coryell
Jess
J
Fiedorowicz
Andrew C
AC
Leon
Jean
J
Endicott
Martin B
MB
Keller
D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult