Clinical presentation of mania compared with depression: data from a geriatric clinic in India

Background: This retrospective chart review evaluated a comparison of the clinical profiles of older outpatients having mania and those with unipolar depression. Methods: The charts of elderly outpatients with mania and unipolar depression in tertiary care settings were reviewed and relevant information incorporated regarding clinical presentation, past and family history of affective disorder, treatment history and previous psychiatric and neurological history. Results: Charts for 30 patients with mania (23 men and 7 women with mean (+/- SD) age of 68.5 (+/- 5.75 years) and 92 with depression (47 men and 45 women with mean (+/- SD) age of 68.18 (+/- 6.0 years) were evaluated. Fifteen patients (50%) with manic episodes had psychotic symptoms in the form of delusions and hallucinations while only 33 (35.8%) depressed patients had psychotic symptoms. One-third of manic patients received mood stabilizers at index visit. More than half (n = 163-53.3%) of the patients in the mania group were prescribed antipsychotic medications. On cognitive functions, patients with manic episodes scored poorly compared with those with depression. Conclusions: These findings suggest that mania in the elderly is a severe form of affective disorder with respect to psychotic and cognitive symptoms. Conclusions from this study are limited due to its retrospective design. Further studies in this area are warranted.