在老年双相障碍患者中，发病年龄具有临床意义吗？
Does age at onset have clinical significance in older adults with bipolar disorder?
机构信息
Advanced Center for Intervention and Services Research for Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA.
出版信息
Int J Geriatr Psychiatry. 2010 Dec;25(12):1266-71. doi: 10.1002/gps.2466.
OBJECTIVE
While age at onset may be useful in explaining some of the heterogeneity of bipolar disorder (BD) in large, mixed age groups, investigations to date have found few meaningful clinical differences between early versus late age at onset in older adults with BD.
METHODS
Data were collected from sixty-one subjects aged 60 years and older, mean (SD) age 67.6 (7.0), with BD I (75%) and II (25%). Subjects were grouped by early (< 40 years; n = 43) versus late (≥ 40 years; n = 18) age at onset. Early versus late onset groups were compared on psychiatric comorbidity, medical burden, and percentage of days well during study participation.
RESULTS
Except for family history of major psychiatric illnesses, there were no differences between the groups on demographic or clinical variables. Patients with early and late onset experienced similar percentages of days well; however, those with early onset had slightly more percentage of days depressed than those with late onset (22% versus 13%)
CONCLUSION
Distinguishing older adults with BD by early or late age at onset has limited clinical usefulness.
目的
虽然发病年龄可能有助于解释在年龄较大的混合年龄组中双相情感障碍（BD）的一些异质性，但迄今为止的研究发现，在年龄较大的 BD 患者中，发病年龄早与晚之间几乎没有明显的临床差异。
方法
从 61 名年龄在 60 岁及以上、平均（SD）年龄为 67.6（7.0）岁的患有 BD I（75%）和 II（25%）的患者中收集数据。根据发病年龄（< 40 岁；n = 43）和晚（≥ 40 岁；n = 18）将患者分为两组。比较早发和晚发组在精神共病、医疗负担和研究期间病情良好天数百分比方面的差异。
结果
除了主要精神疾病家族史外，两组在人口统计学或临床变量方面无差异。早发和晚发患者的病情良好天数百分比相似；然而，早发患者的抑郁天数百分比略高于晚发患者（22%比 13%）。
结论
根据发病年龄将年龄较大的 BD 患者分为早发和晚发，临床意义有限。
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