Age of onset affects clinical outcomes in bipolar

Developing bipolar 1 disorder at an early age is associated with worse clinical outcomes, an Australian study finds. Melbourne and Sydney researchers examined the outcomes of 239 patients who were enrolled in the Bipolar Comprehensive Outcomes Study, a two-year longitudinal, observational, cross-sectional study. The participants were divided into three “age of onset” groups: under 20 years, 20-39 years and 40 years and above, however only the early and intermediate group were large enough to include in the statistical analysis. The study found that the earliest age of onset group experienced a (non-statistically significant) trend towards more depressive symptoms (assessed by the HAMD rating scale) and statistically significant higher rates of suicidal ideation (0.52 vs 0.14 p=0.02). Interestingly, while there were no significant differences between the early and intermediate groups in objective quality of life measures such as income and involvement in a relationship, the early onset group experienced more frequent psychological distress, more subsequent social and role disability, and felt more dissatisfied with their lives. “This could be due to the fact that this group [is] more depressed, and therefore tended to perceive that their quality of life was impacted more negatively,” the study authors said. “The relationship of the AAO of bipolar disorder with the course of illness and outcomes is significant [and] has important implications for the early detection, intervention and overall treatment of the disorder,” they concluded. The study was funded by Eli Lilly. Acta Neuropsychiatrica 2009: 21: 191–196...