title: Two years' outcome of acute mania in bipolar disorder: different effects of age and age of onset.
abstract: BACKGROUND
  Information about differences between younger and older patients with bipolar disorder and between older patients with early and late age of onset of illness during long-term treatment is scarce.
  
  
  OBJECTIVE
  This study aimed to investigate the differences in treatment and treatment outcome between older and younger manic bipolar patients and between early-onset bipolar (EOB) and late-onset bipolar (LOB) older patients.
  
  
  METHODS
  The European Mania in Bipolar Longitudinal Evaluation of Medication study was a 2-year prospective, observational study in 3459 bipolar patients on the treatment and outcome of patients with an acute manic or mixed episode. Patients were assessed at 6, 12, 18, and 24 months post-baseline. We calculated the number of patients with a remission, recovery, relapse, and recurrence and the mean time to achieve this.
  
  
  RESULTS
  Older patients did not differ from younger bipolar patients in achieving remission and recovery or suffering a relapse and in the time to achieve this. However, more older patients recurred and in shorter time. Older patients used less atypical antipsychotics and more antidepressants and other concomitant psychiatric medication. Older EOB and LOB patients did not differ in treatment, but more older LOB patients tended to recover than older EOB patients.
  
  
  CONCLUSIONS
  Older bipolar manic patients did not differ from younger bipolar patients in short-term treatment outcome (remission and recovery), but in the long term, this may be more difficult to maintain. Distinguishing age groups in bipolar study populations may be useful when considering treatment and treatment outcome and warrants further study.
authors.affiliation: Department of Old Age Psychiatry, GGZ Haagstreek (Rivierduinen), Leidschendam, The Netherlands.
authors.forename: Frits
authors.initials: F
authors.lastname: Oostervink
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.forename: Rob M
authors.initials: RM
authors.lastname: Kok
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: age of onset; bipolar disorder; older; outcome; therapeutics