Abstract
BackgroundAlthough manic episodes in older adults are not rare, little published data exist on late-life manic episodes. Resistance to treatment and concomitant neurological lesions are frequent correlates of elderly mania. The aim of this study was to investigate the prevalence of hospitalizations due to mania in patients older than 64 years through a period of 5 years in an Italian public psychiatric ward. Moreover, we aimed at describing clinical presentation of elderly manic episodes.MethodsA retrospective chart review was conducted in order to describe clinical presentation of 20 elderly patients hospitalized for manic episode; moreover, we compared age at onset, the presence of family history for mood disorders, psychosis and irritability between the elderly group and a matched group of 20 younger manic inpatients.ResultsSeven percent of the whole inpatient elderly people suffered from mania. Half of those patients had a mood disorder age at onset after 50 years and 5 patients were at their first manic episode. Geriatric- and adulthood mania showed similar clinical presentation but younger people had more frequently a mood disorders family history.ConclusionHalf of our older manic inpatients consisted of "classic" bipolar patients with an extension of clinical manifestations into later life; the other half of our sample was heterogeneous, even though it was not possible to identify clearly which patients may have had vascular lesions related to the onset of mania.
Highlights
Manic episodes in older adults are not rare, little published data exist on late-life manic episodes
We aimed at describing clinical features of older manic patients and we compared age at onset, presence of family history for mood disorders, psychosis and irritability in the older patients sample and in a sample of manic inpatients under the age of 65 years
Seven percent (7%) of all inpatients above 64 years of age had been discharged with a diagnosis of mania according to DSM-IV criteria
Summary
Manic episodes in older adults are not rare, little published data exist on late-life manic episodes. Studies comparing mania in older and younger adults have found no substantial differences in clinical presentation It has been suggested, that mania in older patients is less severe and manifests with more irritability, confusion, psychosis, and mixed features [4]. Clinical Practice and Epidemiology in Mental Health 2008, 4:22 http://www.cpementalhealth.com/content/4/1/22 Age at onset, another topic of investigation in research conducted on bipolar disorder (BD) in older people, has been proposed as representing a specifier for more homogeneous groups of BD families, facilitating the mapping of susceptibility genes thereby [5]. Another topic of investigation in research conducted on bipolar disorder (BD) in older people, has been proposed as representing a specifier for more homogeneous groups of BD families, facilitating the mapping of susceptibility genes thereby [5] In this line, several findings from literature reported higher rates of family history in younger bipolar people [6]. We aimed at describing clinical features of older manic patients and we compared age at onset, presence of family history for mood disorders, psychosis and irritability in the older patients sample and in a sample of manic inpatients under the age of 65 years
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