Admixture analysis of age at onset in bipolar disorder

Tozzi, Federica; Manchia, Mirko; Galwey, Nicholas; Severino, Giovanni; Zompo, Maria Del; Day, Richard; Matthews, Keith; Strauss, John S.; Kennedy, James L.; McGuffin, Peter; Vincent, John B.; Farmer, Anne; Muglia, Pierandrea

doi:10.1016/j.psychres.2009.11.025

Cited by 53 publications

(62 citation statements)

References 27 publications

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“…The bimodal AAO distribution found in both BD diagnostic subgroups and in the whole sample of 515 patients is consistent with some studies (Ortiz et al 2011;Kennedy et al 2005;Javaid et al 2011). Conversely, the majority of studies on mixture analysis of AAO showed a trimodal distribution in samples comprising mainly BD1 patients (Bellivier et al 2001(Bellivier et al , 2003Lin et al 2006;Severino et al 2009;Hamshere et al 2009;Tozzi et al 2011;Bellivier et al 2014;Golmard et al 2015). Of note, a recent study showed that bimodal and trimodal distribution fit equally well the AAO of BD (GrigoroiuSerbanescu et al 2014).…”

Section: Discussionsupporting

confidence: 82%

“…In fact, thresholds between subgroups found in different studies differed [e.g. thresholds between the intermediate and late AAO subgroups differed from 25 in one study (Tozzi et al 2011) to 40 years in another (Hamshere et al 2009)] as well as percentages of patients in each AAO subgroups [e.g. percentages of patients attributed to the early onset subgroup varied between 21.4% (Bellivier et al 2001) and 79.7% (Lin et al 2006)].…”

Section: Discussionmentioning

confidence: 99%

“…Although our study did not test for association most of these clinical correlates, there were no statistically significant associations with EO for drug dependence. Of note, most of this evidence is derived from BD1 samples as there is a lack of data on the analysis of AAO in BD2, while only a few studies investigated mixed samples with both BD1 and BD2 patients (Perlis et al 2004;Severino et al 2009;Tozzi et al 2011;Ortiz et al 2011;Propper et al 2015).…”

Section: Discussionmentioning

confidence: 99%

“…The magnitude of clinical heterogeneity might be reduced by studying subgroups of BD patients sharing specific clinical characteristics such as patterns of treatment response (Alda et al 2005), mood incongruent psychosis (Goes et al 2007), or early illness onset (Jamain et al 2014). Indeed, the extensive analysis of age at onset (AAO) BD subgroups through admixture analysis has shown clinical (Bellivier et al 2001;Lin et al 2005;Manchia et al 2008;Tozzi et al 2011;Ortiz et al 2011) and genetic (Etain et al 2006;Severino et al 2009;Etain et al 2010;Belmonte et al 2011) characteristics specific, particularly, to early onset (EO) BD.…”

Section: Introductionmentioning

confidence: 99%

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Clinical correlates of age at onset distribution in bipolar disorder: a comparison between diagnostic subgroups

Manchia¹,

Maina²,

Carpiniello³

et al. 2016

European Neuropsychopharmacology

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Background: Admixture analysis of age at onset (AAO) has helped delineating the clinical profile of early onset (EO) bipolar disorder (BD). However, there is scarce evidence comparing the distributional properties of AAO as well as the clinical features of EO BD type 1 (BD1) with EO BD type 2 (BD2). To this end, we studied 515 BD patients (224 BD1, 279 BD2, and 12 BD not otherwise specified [NOS]) diagnosed according to DSM-IV-TR criteria.Methods: AAO was defined as the first reliably diagnosed hypo/manic or depressive episode according to diagnostic criteria. We used normal distribution mixture analysis to identify subgroups of patients according to AAO. Models were chosen according to the Schwarz's Bayesian information criteria (BIC). Clinical correlates of EO were analysed using univariate tests and multivariate logistic regression models. Results:A two normal components model best fitted the observed distribution of AAO in BD1 (BIC = −1599.3), BD2 (BIC = −2158.4), and in the whole sample (BIC = −3854.9). A higher number of EO BD2 patients had a depression-(hypo)mania-free interval (DMI) course, while a higher rate of (hypo)mania-depression-free interval (MDI) course was found in EO BD1. EO BD2 had also a higher rate of comorbidity with alcohol dependence compared to EO BD1. The latter finding was confirmed by multivariate logistic regression analysis. Conclusions:In conclusion, both BD1 and BD2 had bimodal AAO distributions, but EO subgroups had a diagnosticspecific clinical delineation.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical correlates of age at onset distribution in bipolar disorder: a comparison between diagnostic subgroups

Manchia¹,

Maina²,

Carpiniello³

et al. 2016

European Neuropsychopharmacology

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“…3 However, patients might delay presenting to a clinician until they have been ill several times or until they are manic. Some patients with recurrent depression may have had a previous hypomanic episode that was overlooked and may, in fact, have bipolar disorder.…”

Section: Presentation and Diagnosismentioning

confidence: 99%

Mood instability versus bipolar disorder: what to look for

Harpur¹,

Harris²,

Masson³

2018

Prescriber

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Paternal age effect on age of onset in bipolar I disorder is mediated by sex and family history

Grigoroiu‐Serbanescu

Wickramaratne

Mihailescu

et al. 2012

American J of Med Genetics Pt B

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This study investigated for the first time in the psychiatric literature the effect of parental age on age-of-onset (AO) in bipolar I disorder (BPI) in relation to proband sex and family history (FH) for major psychoses in a sample of 564 BPI probands. All probands, 72.68% of their first-degree and 12.13% of their second-degree relatives were directly interviewed. The FH-method was used for all unavailable relatives. The diagnoses were made according to DSM-IV(TR) . The impact of parental age on proband early/late AO was evaluated through logistic regression with the cut-off for early AO determined through commingling analysis. We found evidence for a significant influence of increasing paternal age, and especially age ≥ 35 years, on AO of BPI disorder in the total sample (OR = 0.54, CI: 0.35-0.80), in the female subsample (OR = 0.44, CI: 0.25-0.78), in the sporadic subsample (OR = 0.64, CI: 0.38-0.95), and in the subsample with FH of recurrent unipolar major depression (Mdd-RUP) (OR = 0.55, CI: 0.34-0.87). No significant effect of paternal age on disease AO was found in patients with FH of bipolar (BP), schizoaffective disorders (SA), or schizophrenia (SCZ), nor in males. Mean age was significantly higher in fathers of sporadic cases and of cases with FH of Mdd-RUP than in fathers of cases with FH of BP/SA/SCZ (P = 0.011). Maternal age had no significant effect either in the total sample or in subsamples defined by proband sex or FH. In conclusion, in our sample increasing paternal age lowered the onset of BPI selectively, the effect being related to the female sex and FH-type.

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Admixture analysis of age at onset in bipolar disorder

Cited by 53 publications

References 27 publications

Clinical correlates of age at onset distribution in bipolar disorder: a comparison between diagnostic subgroups

Clinical correlates of age at onset distribution in bipolar disorder: a comparison between diagnostic subgroups

Mood instability versus bipolar disorder: what to look for

Paternal age effect on age of onset in bipolar I disorder is mediated by sex and family history

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