P3-128: Psychopathologies and clinical characteristics of late-onset manic episodes

Many studies suggested that bimodality in age of onset of bipolar disorder could present different clinical characteristics between early- and late-onset manic episodes. However, wide varieties of age cut-off and the different results of clinical features across studies made it difficult to conclude with consistency of the clinical characteristics of late onset manic episodes. Therefore, the aim of this study is to compare the clinical characteristics including psychopathologies between early- and late- onset manic episode. The study subjects included patients admitted to the department of psychiatry of a University Hospital from January 2010 to July 2014, who met DSM-IV-TR criteria for bipolar I disorder, manic episode. The medical records were reviewed retrospectively by two psychiatrists. Subjects who had the first onset of manic episode under the age of 25 were grouped as the early onset group, whereas those who had the first onset of manic episode after the age of 50 were grouped as the late onset group. The clinical characteristics and psychopathologies between two groups were analyzed with Chi-square test, t-test, Mann-Whitney test. The number of patients in the early onset group and late onset group were 17 and 21 respectively. The late onset group had greater medical (p<0.001) and neurological comorbidities (p=0.024), shorter mean length of hospital stay (p=0.005) and less Young mania rating scale scores (p=0.033). The severity of Elevated mood (p=0.05), Sexual interest (p=0.016), and Disruptive/Aggressive behavior (p=0.042) of Young mania rating scale were lower in the late onset group than those of the early onset group. This study suggests that the severity of manic episode in the late onset group is milder than that in the early onset group and there are differences in the clinical characteristics among different age onset groups.