The impact of age at onset of bipolar I disorder on functioning and clinical presentation.
OBJECTIVE
Recent studies have proposed the existence of three distinct subgroups of bipolar 1 disorder based on age at onset (AAO). The present study aims to investigate potential clinical and functional differences between these subgroups in an Australian sample.


METHODS
Participants (n = 239) were enrolled in the Bipolar Comprehensive Outcomes Study (BCOS), a 2-year longitudinal, observational, cross-sectional study. Assessment measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD21), Clinical Global Impressions Scale (CGI-BP), SF-36, SLICE/Life Scale, and the EuroQol (EQ-5D). Participants were also asked about their age at the first major affective episode.


RESULTS
Three AAO groups were compared: early (AAO < 20, mean = 15.5 ± 2.72; 44.4% of the participants); intermediate (AAO 20-39, mean = 26.1 ± 4.8; 48.14% of the participants) and late (AAO > 40, mean = 50.6 ± 9.04; 7.4% of the participants). Higher rates of depression, suicidal ideation and binge drinking were reported by the early AAO group. This group also reported poorer quality of life in a number of areas. The early AAO group had a predominant depressive initial polarity and the intermediate group had a manic predominance.


CONCLUSIONS
Early AAO is associated with an adverse outcome.
1Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Frances
F
Biffin
1Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Steven
S
Tahtalian
1Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Kate
K
Filia
1Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Paul B
PB
Fitzgerald
1Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Anthony R
AR
de Castella
1Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Sacha
S
Filia
2Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
Michael
M
Berk
2Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
Seetal
S
Dodd
2Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
Pam
P
Callaly
2Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
Lesley
L
Berk
3Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia.
Katarina
K
Kelin
4School of Social Sciences, University of Western Sydney, Penrith South Dc, Australia.
Meg
M
Smith
3Eli Lilly Australia Pty Ltd, 112 Wharf Road, West Ryde, Australia.
William
W
Montgomery
1Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Jayashri
J
Kulkarni