The impact of age at onset of bipolar I disorder on functioning and clinical presentation

Frances Elizabeth Biffin, Stavros Steven Tahtalian, Kate M Filia, Paul Bernard Fitzgerald, Rolet Anthony De Castella, Sacha Louise Filia, Michael Berk, Seetal Dodd, Pam Callaly, Lesley A Berk, Katarina Kelin, Meg M Smith, William Montgomery, Jayashri Kulkarni

Research output: Contribution to journalArticleResearchpeer-review

18 Citations (Scopus)


Objectives: Recent studies have proposed the existence of three distinct subgroups of bipolar 1 disorder based on age at onset (AAO). The present study aims to investigate potential clinical and functional differences between these subgroups in an Australian sample. Methods: Participants (n = 239) were enrolled in the Bipolar Comprehensive Outcomes Study (BCOS), a 2-year longitudinal, observational, cross-sectional study. Assessment measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD21), Clinical Global Impressions Scale (CGI-BP), SF-36, SLICE/Life Scale, and the EuroQol (EQ-5D). Participants were also asked about their age at the first major affective episode. Results: Three AAO groups were compared: early (AAO <20, mean = 15.5 ? 2.72; 44.4 of the participants); intermediate (AAO 20-39, mean = 26.1 ? 4.8; 48.14 of the participants) and late (AAO > 40, mean = 50.6 ? 9.04; 7.4 of the participants). Higher rates of depression, suicidal ideation and binge drinking were reported by the early AAO group. This group also reported poorer quality of life in a number of areas. The early AAO group had a predominant depressive initial polarity and the intermediate group had a manic predominance. Conclusion: Early AAO is associated with an adverse outcome. ? 2009 John Wiley Sons A/S.
Original languageEnglish
Pages (from-to)191 - 196
Number of pages6
JournalActa Neuropsychiatrica
Issue number4
Publication statusPublished - 2009

Cite this