Lehmann Susan W, Rabins Peter V
The Johns Hopkins University School of Medicine, Baltimore, MD 21287-7279, USA.
Int J Geriatr Psychiatry. 2006 Nov;21(11):1060-4. doi: 10.1002/gps.1607.
To identify factors contributing to relapse and hospitalization in elderly patients with bipolar disorder.
Retrospective chart review surveyed consecutive patients over age 65 admitted to the Johns Hopkins Hospital for a manic episode over a five year period (n=73). Factors precipitating index admission were compared in patients with early-onset bipolar disorder (<or=age 45, n=38) and late-onset bipolar disorder (>age 45, n=35).
The distribution of ages of onset of bipolar disorder was most consistent with a bimodal pattern with a cut-point at age 45. Early-onset patients were more likely to have been aggressive and threatening prior to admission (p=0.014) compared to late-onset patients and were more likely to have been brought to the emergency room on emergency petition for evaluation (p=0.028). Early-onset patients were also more likely to have been non-adherent with prescribed psychiatric medication (p=0.032).
Relapse and rehospitalization were common among elderly manic patients with early-onset and late-onset bipolar disorder. Strategies which improve medication adherence are needed to help prevent recurring hospitalization.
确定导致老年双相情感障碍患者复发和住院的因素。
回顾性病历审查调查了连续5年因躁狂发作入住约翰霍普金斯医院的65岁以上患者（n = 73）。比较早发性双相情感障碍（≤45岁，n = 38）和晚发性双相情感障碍（> 45岁，n = 35）患者导致首次入院的因素。
双相情感障碍的发病年龄分布最符合双峰模式，分界点为45岁。与晚发性患者相比，早发性患者入院前更有可能具有攻击性和威胁性（p = 0.014），并且更有可能因紧急评估申请而被送往急诊室（p = 0.028）。早发性患者也更有可能不依从规定的精神科药物治疗（p = 0.032）。
早发性和晚发性双相情感障碍的老年躁狂患者复发和再次住院很常见。需要采取提高药物依从性的策略来帮助预防再次住院。
