Benedetti Alessandra, Scarpellini Pietro, Casamassima Francesco, Lattanzi Lorenzo, Liberti Maria, Musetti Laura, Cassano Giovanni Battista
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, University of Pisa, Via Roma, 67, Pisa, Italy.
Clin Pract Epidemiol Ment Health. 2008 Jul 29;4:22. doi: 10.1186/1745-0179-4-22.
Although 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.
A 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.
Seven 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.
Half 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.
尽管老年期躁狂发作并不罕见，但关于晚年躁狂发作的已发表数据很少。治疗抵抗和伴随的神经病变是老年躁狂症的常见相关因素。本研究的目的是通过一项为期5年的研究，调查意大利一家公立精神科病房中64岁以上患者因躁狂发作住院的患病率。此外，我们旨在描述老年躁狂发作的临床表现。
进行了一项回顾性病历审查，以描述20例因躁狂发作住院的老年患者的临床表现；此外，我们比较了老年组与20例年轻躁狂症住院患者的匹配组之间的发病年龄、情绪障碍家族史、精神病和易怒情况。
住院老年患者中有7%患有躁狂症。这些患者中有一半在50岁以后发病，5例为首次躁狂发作。老年期和成年期躁狂症表现出相似的临床表现，但年轻人有情绪障碍家族史的情况更为常见。
我们一半的老年躁狂症住院患者为“典型”双相情感障碍患者，其临床表现延续至晚年；我们样本的另一半情况各异，尽管无法明确确定哪些患者可能患有与躁狂发作相关的血管病变。
