title: Childhood abuse, family history and stressors in older patients with bipolar disorder in relation to age at onset.
abstract: OBJECTIVE
  The aim of this study is to explore the family history of psychiatric disorders, childhood abuse, and stressors in older patients with Bipolar Disorder (BD) and the association of these variables with the age at onset of BD.
  
  
  METHODS
  The Questionnaire for Bipolar Disorder (QBP) and the Mini International Neuropsychiatric Interview (MINI-Plus) were obtained from 78 patients aged 60 and over to determine diagnosis, age at onset of the first affective episode, childhood abuse, family history of psychiatric disorders and past and recent stressful life events.
  
  
  RESULTS
  Increased family history of psychiatric disorders was the only factor associated with an earlier age at onset of BD. Less family history of psychiatric disorders and more negative stressors were significantly associated with a later age at onset of the first (hypo)manic episode.
  
  
  CONCLUSIONS
  Age at onset, history of childhood abuse, and past stressful life events were assessed retrospectively. Family members of BD patients were not interviewed.
  
  
  CONCLUSIONS
  Our findings suggest that age at onset can define distinct BD phenotypes. More specifically there was a stronger heredity of BD and other psychiatric disorders in patients with an early age of onset of BD. Negative stressors may play a specific role in patients with a late age at onset of a first (hypo)manic episode.
authors.affiliation: Department of Old Age Psychiatry GGZ inGeest/VUmc, Amsterdam, The Netherlands.
authors.forename: C S
authors.initials: CS
authors.lastname: Thesing
authors.affiliation: Department of Old Age Psychiatry GGZ inGeest/VUmc, Amsterdam, The Netherlands.
authors.forename: M L
authors.initials: ML
authors.lastname: Stek
authors.affiliation: Department of Old Age Psychiatry GGZ inGeest/VUmc, Amsterdam, The Netherlands.
authors.forename: D S
authors.initials: DS
authors.lastname: van Grootheest
authors.affiliation: Department of Epidemiology and Biostatistics, VUmc, Amsterdam, The Netherlands.
authors.forename: P M
authors.initials: PM
authors.lastname: van de Ven
authors.affiliation: Department of Psychiatry GGZ inGeest/VUmc, Amsterdam, The Netherlands.
authors.forename: A T
authors.initials: AT
authors.lastname: Beekman
authors.affiliation: Department of Psychiatry GGZ inGeest/VUmc, Amsterdam, The Netherlands.
authors.forename: R W
authors.initials: RW
authors.lastname: Kupka
authors.affiliation: Department of Old Age Psychiatry GGZ inGeest/VUmc, Amsterdam, The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Comijs
authors.affiliation: Department of Old Age Psychiatry GGZ inGeest/VUmc, Amsterdam, The Netherlands. Electronic address: a.dols@ggzingeest.nl.
authors.forename: A
authors.initials: A
authors.lastname: Dols
mesh_terms: D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Age at onset; Bipolar disorder; Childhood abuse; Family history; Stressors