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Bipolar disorder in the elderly: a cohort study comparing older and younger patients

Authors

  • A. M. A. Nivoli,

    1. Bipolar Disorders Unit, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
    2. Department of Neuroscience, Institute of Psychiatry, University of Sassari, Sassari, Italy
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  • A. Murru,

    1. Bipolar Disorders Unit, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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  • I. Pacchiarotti,

    1. Bipolar Disorders Unit, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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  • M. Valenti,

    1. Bipolar Disorders Unit, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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  • A. R. Rosa,

    1. Laboratory of Molecular Psychiatry, Centro de Pesquisas Experimentais, Hospital de Clínicas de Porto Alegre, INCT for Translational Medicine, Porto Alegre, Brazil
    2. Centro Universitário La Salle, Canoas, RS, Brazil
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  • D. Hidalgo,

    1. Hospital Clinic, Barcelona, Catalonia, Spain
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  • V. Virdis,

    1. Geriatric Unit, Civil Hospital, Sassari, Italy
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  • S. Strejilevich,

    1. Bipolar Disorder Program, Neurosciences Institute, Favaloro University & Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
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  • E. Vieta,

    Corresponding author
    1. Bipolar Disorders Unit, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
    • Eduard Vieta, Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clinic, Villarroel 170, 9-0, Barcelona 08036, Catalonia, Spain.

      E-mail: evieta@clinic.ub.es

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  • F. Colom

    1. Bipolar Disorders Unit, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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Abstract

Objective

The purpose of this study was to analyze differences in clinical and socio-demographic characteristics between older and younger bipolar outpatients paying special attention to depressive symptoms in a large, naturalistic cohort.

Method

Five hundred and ninety-three DSM-IV-TR bipolar outpatients were enrolled. Clinical characteristics were assessed according to DSM-IV-TR (SCID-I). Subjects were categorized into two groups according to current age (older OBD: age > 65 years; younger-YBD: age < 65 years).

Results

About 80% of patients were younger (N = 470), and a fifth were older (N = 123), with a mean age of 77.30 years in OBD. Older patients were more likely to be married, not qualified, bipolar II, with depressive polarity of first episode, higher age at illness onset, higher age at first hospitalization. They were more likely to present with depressive predominant polarity, with lifetime history of catatonic, psychotic and melancholic features, age at illness onset >40 years, as well as suffering from more medical comorbidities when compared to younger bipolars.

Conclusion

The clinical presentation of bipolar disorder in late life would be defined more frequently by melancholic depressive features and a predominantly depressive polarity. These results suggest that treatment strategies for elderly bipolar patients should focus in the prevention of depressive episodes.

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