Abstract

Introduction: There are suggestions that age-at-onset (AAO) of bipolar disorder may differ geographically and (AAO) may influence the clinical characteristics. Lack of any published data from eastern part of Nepal prompted this studyObjective: The aim of the study was to find the mean AAO in admitted patients in a tertiary care hospital from eastern part of Nepal and to study the association of clinical variables with AAO.Method: Retrospective analysis was done of bipolar in-patients’ case-records (N=229) who were discharged from 2012 to 2014. Diagnosis was based on International Classification of Diseases, Clinical Descriptions and Diagnostic Guidelines, tenth version (ICD-10). All variables from files were noted in a Performa prepared by the department for the purpose. Mean AAO was determined. The association of early-onset (below or equal to 18 years of age) and late-onset (later than 18 years) with clinical variables (comorbidity, family history, lifetime presence of psychosis and suicidal attempts) was assessed with Chi-Square test (0.05).Result: Mean AAO was 23.97 (SD 8.7) years. AAO was significantly associated with comorbidity and not significantly associated with family history of bipolar disorder, lifetime presence of psychotic symptoms or suicidal attempt(s).Conclusion: AAO and comorbidity are associated. Present findings need to be seen with the limitation of the study.

Highlights

  • There are suggestions that age-at-onset (AAO) of bipolar disorder may differ geographically and (AAO) may influence the clinical characteristics

  • The age-at-onset (AAO) is a method to look for homogeneous group within the phenotypic heterogeneity of bipolar disorders

  • The case records of 229 in-patients discharged with the diagnosis of bipolar affective disorder from 2012 to 2014 were analyzed. The diagnoses in this centre were based on International Classification of Disease-Clinical Descriptions and Diagnostic Guidelines, tenth version (ICD-10)15 - by World Health Organization for psychiatric disorders and is verified by at least one consultant psychiatrist

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Summary

Introduction

There are suggestions that age-at-onset (AAO) of bipolar disorder may differ geographically and (AAO) may influence the clinical characteristics. The association of early-onset (below or equal to 18 years of age) and late-onset (later than 18 years) with clinical variables (comorbidity, family history, lifetime presence of psychosis and suicidal attempts) was assessed with Chi-Square test (0.05). AAO was significantly associated with comorbidity and not significantly associated with family history of bipolar disorder, lifetime presence of psychotic symptoms or suicidal attempt(s). The lifetime prevalence rate of bipolar I disorder may range from 0-2.4% with onset ranging five years to 50 years or more. David et al in 2009 reported that late AAO bipolar patients were more likely to present with psychosis compared with early AAO6; McElroy et al and Kennedy et al demonstrated more likelihood of psychotic

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