Episodic density, subsyndromic symptoms, and mood instability in late-life bipolar disorders: A 5-year follow-up study

被引:13
作者
Strejilevich, Sergio [1 ,2 ]
Szmulewicz, Alejandro [1 ,3 ,4 ]
Igoa, Ana [1 ]
Marengo, Eliana [1 ]
Caravotta, Pablo [1 ]
Martino, Diego [1 ,5 ]
机构
[1] AREA, Assistance & Res Affect Disorders, Buenos Aires, DF, Argentina
[2] Favaloro Univ, Neurosci Inst, Bipolar Disorder Program, Juncal 2061 PB C,C1116AAE, Buenos Aires, DF, Argentina
[3] Harvard TH Chan Sch Publ Hlth, Boston, MA USA
[4] Univ Buenos Aires, Dept Pharmacol, Buenos Aires, DF, Argentina
[5] Consejo Nacl Invest Cient & Tecn, Natl Sci & Tech Res Council, Buenos Aires, DF, Argentina
关键词
bipolar disorder; late life; mood instability; older age bipolar disorder; psychosocial; subsyndromal; ILLNESS; DEFINITION; RECOVERY; AGE;
D O I
10.1002/gps.5094
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives Characterization of clinical course in old age bipolar disorder (OABD) is scarce and based solely on episode density (ED). The aim of this study was to explore mood instability (MI) and subsyndromal symptomatology (SS) in a prospective cohort of OABD. Further, we contrasted these measures with a cohort of young age bipolar disorder (YABD). Methods Life charts from weekly mood ratings were used to compute the number of weeks spent with subsyndromal symptoms (SD), the ED, and the MI during follow-up for a cohort of OABD (N = 38) that excluded late onset BD. Linear and logistic regression models were fitted to compare the clinical course of OABD with a cohort of YABD (N = 52) and to explore the relationship between these measures and functional outcomes. Results Median follow-up was 5 years (IQR: 3.6-7.9). OABD (61.6 years, SD: 8.3) spent 15%, 6%, and 3% of their follow-up with depressive, manic, and mixed symptoms, respectively, and suffered 4.2 mood changes per year (SD: 2.6). No significant differences between OABD and YABD regarding ED or MI emerged in multivariate analysis, while a higher subsyndromal manic symptom burden was observed in OABD (beta coefficient: 3.79, 95%CI: 0.4-7.2). Both SS and MI were associated with functional outcomes in OABD. Conclusions The course of illness throughout OABD was similar to the one observed in YABD except for a higher subsyndromal manic burden. This study extended the association of MI and SD with global functioning to the late-life BD.
引用
收藏
页码:950 / 956
页数:7
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