title: Correlates of disability in depressed older adults with bipolar disorder.
abstract: Aims To identify clinical factors associated with disability in depressed older adults with bipolar disorder (BPD) receiving lamotrigine. Methods Secondary analysis of a multi-site, 12-week, open-label, uncontrolled study of addon lamotrigine in 57 adults 60 years and older with BD I or II depression. Measures included the Montgomery Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Cumulative Illness Rating Scale for Geriatrics (CIRS-G), Dementia Rating Scale (DRS), and WHO-Disability Assessment Scale II (WHO-DAS II). Results Medical comorbidiy in this group of elders was substantial, with roughly 60% of subjects having disorders of the vascular, musculoskeletal/integument, and endodrine/metabolic/breast systems. We found significant relationships among mood (MADRS), medical comorbidity (CIRS-G), cognition (DRS), and disability (WHO-DAS II). More severe BPD depression, more medical comorbidity and more impaired cognition were all associated with lower functioning in BPD elders. Conclusions Our findings fit the paradigm shift that has been occurring in BPD, supporting the notion that BPD is not solely an illness of mood but that it affects multiple domains impacting overall functioning.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic.
authors.forename: Ariel
authors.initials: A
authors.lastname: Gildengers
authors.affiliation: Department of Neurology, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center.
authors.forename: Curtis
authors.initials: C
authors.lastname: Tatsuoka
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bialko
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Cassidy
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center.
authors.forename: Philipp
authors.initials: P
authors.lastname: Dines
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic.
authors.forename: James
authors.initials: J
authors.lastname: Emanuel
authors.affiliation: Mental Health Care Line, Michael E. DeBakey, VA medical Center, Baylor College of Medicine.
authors.forename: Rayan K
authors.initials: RK
authors.lastname: Al Jurdi
authors.affiliation: University of Pennsylvania Medical Center and School of Medicine.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Gyulai
authors.affiliation: Centre for Addiction and Mental Health, University of Toronto.
authors.forename: Benoit H
authors.initials: BH
authors.lastname: Mulsant
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Young
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center.
authors.forename: Martha
authors.initials: M
authors.lastname: Sajatovic
keywords: anticonvulsant; bipolar disorder; depression; elderly; geriatric; lamotrigine; mood stabilizer