First Episode Mania at the Age of 78 Years: A Case Report

Dhonju, Gunjan; Pm, Singh; Joshi, Niranjan

doi:10.3126/jpan.v3i1.11352

Cited by 1 publication

(1 citation statement)

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“…Finally, we have only 3 case reports with primary psychiatric diagnosis of first episode mania with age of onset at 75, 78 and 88 years as illustrated in Table 1. 6,7,8 The current case and previous similar case reports highlight the importance of recognizing late-onset primary psychiatric diagnosis. Since majority of late onset psychiatric disorders are secondary to comorbidity so in elderly before making final diagnosis clinician should emphasize on ruling out possible secondary causes like vascular mania, multiple sclerosis, Parkinson's disease, temporal lobe epilepsy, acquired immunodeficiency syndrome (AIDS), dementia, and traumatic brain injury.…”

Section: Discussionsupporting

confidence: 68%

Very-late Onset Mania Episode: Case Report and Review of Cases Over 75 Years of Age

Singh¹,

Verma²,

Kumar³

et al. 2019

IJCMR

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Introduction: Bipolar I disorder typically characterized by cycles of depression and mania. Onset after the age of 75 years is very rare and the reported incidence of mania is 2/100000, which most often occur due to secondary organic aetiology. Here we are presenting a review and an interesting case of late-onset first episode mania while evaluating and excluding all other secondary causes of mania. Case Report: 79-year-old male presented with 2 weeks' duration of illness and symptoms was suggestive of a manic episode. The patient was thoroughly assessed with laboratory investigations and non-contrast computerised tomography (NCCT) brain to find any secondary causes of mania but nothing was significant. Finally, as per tenth revision of the International Statistical Classification of Diseases (ICD-10) diagnosis of first episode Mania without psychotic symptoms (F30.1) was made. He was started on Valproate which was gradually increased up to 750 mg/day and olanzapine 5mg. After 6 weeks, the YMRS score decreased from 32 to 8 and he achieved his premorbid functioning level. Conclusion: This case highlights that primary psychiatry illness can occur at any age but in the geriatric population before finalizing the diagnosis all other secondary causes should be ruled out. There is a high need for systematic research in this area to formulate effective management guidelines in the geriatric population.

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Section: Discussionsupporting

confidence: 68%