The Age of Onset of Bipolar Disorders

Dagani, Jessica; Baldessarini, Ross J.; Signorini, Giulia; Nielssen, Olav; Girolamo, Giovanni de

doi:10.1007/978-3-319-72619-9_5

Cited by 8 publications

(7 citation statements)

References 296 publications

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“…A comprehensive review of research studies found a pooled value for OA in BD of 25.3 years (95% confidence interval [CI]: 24.4–26.2), 6 whereas MDD had a broad range of OA with a somewhat later average of 30 years in some studies, 7,8 but as low as 24.8 [CI: 17.2–36.0] years, 9 and with an even younger average OA for MDD than for BD (30 vs. 33 years) in one worldwide study 8 . In BD, in particular, OA may not follow a simple unimodal distribution, but instead can yield bimodal 10–12 or trimodal distributions 13–17 …”

Section: Introductionmentioning

confidence: 99%

“…Its potential value includes support of early differentiation of bipolar (BD) from major depressive disorders (MDD), prediction of the nature and severity of long-term morbidity, and improved separation of familial or potentially genetically based, from sporadic or more environmentally influenced mood disorders, as well as supporting timely interventions with specifically targeted treatments. [1][2][3][4][5] A comprehensive review of research studies found a pooled value for OA in BD of 25.3 years (95% confidence interval [CI]: 24.4-26.2), 6 whereas MDD had a broad range of OA with a somewhat later average of 30 years in some studies, 7,8 but as low as 24.8 [CI: 17.2-36.0] years, 9 and with an even younger average OA for MDD than for BD (30 vs. 33 years) in one worldwide study. 8 In BD, in particular, OA may not follow a simple unimodal distribution, but instead can yield bimodal [10][11][12] or trimodal distributions.…”

Section: Introductionmentioning

confidence: 99%

“…41,[43][44][45] Nevertheless, such associations have been inconsistent, including of earlier-onset mood disorders with family history and with particular forms or severity of later morbidity. 6,14,30,37,38,46,47 In addition, distinguishing older adults with BD versus MDD by early OA may have limited clinical usefulness. [48][49][50] To address unresolved questions about relationships between OA in both BD and MDD, we carried out extensive analyses of relationships of descriptive and clinical characteristics including morbidity with OA, both in predefined early (<18), intermediate , and later (>40 years) OA subgroups as well as with OA as a continuous measure.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, such associations have been inconsistent, including of earlier‐onset mood disorders with family history and with particular forms or severity of later morbidity 6,14,30,37,38,46,47 . In addition, distinguishing older adults with BD versus MDD by early OA may have limited clinical usefulness 48–50 …”

Section: Introductionmentioning

confidence: 99%

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Factors associated with onset‐age in major affective disorders

Miola

Tondo

Salvatore

et al. 2022

Acta Psychiatr Scand

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Background Research findings on factors associated with onset‐age (OA) with bipolar (BD) and major depressive disorders (MDD) have been inconsistent, but often indicate greater morbidity following early OA. Methods We considered factors associated with OA in 1033 carefully evaluated, systematically followed mood disorder subjects with DSM‐5 BD (n = 505) or MDD (n = 528), comparing rates of descriptive and clinical characteristics following early (age <18), intermediate (18–40), or later onset (≥40 years), as well as regressing selected measures versus OA. Exposure time (years ill) was matched among these subgroups. Results As hypothesized, many features were associated with early OA: familial psychiatric illness, including BD, greater maternal age, early sexual abuse, nondepressive first episodes, co‐occurring ADHD, suicide attempts and violent suicidal behavior, abuse of alcohol or drugs, smoking, and unemployment. Other features increased consistently with later OA: %‐time‐depressed (in BD and MDD, women and men), as well as depressions/year and intake ratings of depression, educational levels, co‐occurring medical disorders, rates of marriage and number of children. Conclusions OA averaged 7.5 years earlier in BD versus MDD (30.7 vs. 38.2). Some OA‐associated measures may reflect maturation. Associations with family history and suicidal risk with earlier OA were expected; increases of time‐depressed in both BD and MDD with later OA were not. We conclude that associations of OA with later morbidity are complex and not unidirectional but may be clinically useful.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors associated with onset‐age in major affective disorders

Miola

Tondo

Salvatore

et al. 2022

Acta Psychiatr Scand

Self Cite

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“…The onset of BD is generally from 15 to 35 years of age, but earlier onset is not infrequent. In older years, onset was held to be mostly in adult ages, but it has recently become clear that many more cases have their onset prior to the end of adolescence [ 12 ]. Accordingly, for BD-I patients, onset occurred at an age lower than 12 years of age in 5% of cases, between 13 and 17 years of age (adolescence) in 28% of cases, while 53% occurred during the age range between 15 and 25 years, when the onset of BD peaks [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Not Only Mania or Depression: Mixed States/Mixed Features in Paediatric Bipolar Disorders

et al. 2021

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Background: early onset is frequent in Bipolar Disorders (BDs), and it is characterised by the occurrence of mixed states (or mixed features). In this systematic review, we aimed to confirm and extend these observations by providing the prevalence rates of mixed states/features and data on associated clinical, pharmacological and psychopathological features. Methods: following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched from inception to 9 February 2021 for all studies investigating mixed states/mixed features in paediatric BD. Data were independently extracted by multiple observers. The prevalence rates of mixed states/features for each study were calculated. Results: eleven studies were included in our review, involving a total patient population of 1365 individuals. Overall, of the patients with paediatric age BD, 55.2% had mixed states/features (95% CI 40.1–70.3). Children with mixed states/features presented with high rates of comorbidities, in particular, with Attention Deficit Hyperactivity Disorder (ADHD). Evidences regarding the psychopathology and treatment response of mixed states/features are currently insufficient. Conclusions: our findings suggested that mixed states/features are extremely frequent in children and adolescents with BD and are characterised by high levels of comorbidity. Future investigations should focus on the relationship between mixed states/features and psychopathological dimensions as well as on the response to pharmacological treatment.

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