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The Age of Onset of Bipolar Disorders

  • Jessica Dagani
  • Ross J. Baldessarini
  • Giulia Signorini
  • Olav Nielssen
  • Giovanni de GirolamoEmail author
  • Matthew Large
Chapter

Abstract

Objective: To carry out a systematic review and meta-analysis of age of onset (AoO) of bipolar disorder (BD).

Method: We followed PRISMA guidelines to gather and analyse findings from systematic searches of the PubMed, Web of Science, and Psychology and Behavioral Sciences Collection electronic literature databases. Pooled estimates of the AoO of BD were calculated by random-effects meta-analytic modelling and tested for influences of selected factor by subgroup and meta-regression analyses.

Results: Of the 8,735 initially identified reports, 264 with a total of 65,565 BD patients met inclusion criteria. Pooled AoO was 25.3 years (CI, 24.4–26.2) with high inter-study heterogeneity (95% prediction interval, 11.1–39.5 years). Between countries, AoO estimates ranged from 19.9 years in Hungary to 45.0 years in Croatia. We found a trend towards a younger AoO among people with a positive family history of mood disorder. Factors not found to be associated with reported AoO included current age, sex, publication year, method of estimating AoO, and polarity of first lifetime mood episode. In addition, AoO did not differ between BD-I and BD-II, even with both diagnoses evaluated under matched conditions.

Conclusions: Most patients diagnosed with BD had an onset age between 15 and 35 years, with a pooled mean of 25 years. AoO differed widely among countries. Family history of mood disorder was not associated with younger AoO, although there was a trend towards significance. In contrast to findings of previous individual studies, BD-I diagnosis was not associated with younger AoO. Explaining marked differences in AoO of BD between individual studies and regions requires further research.

Notes

Acknowledgements

Supported in part by a grant from the Bruce J. Anderson Foundation and by the McLean Private Donors Psychiatry Research Fund (to RJB). We are grateful to Drs. Clarissa Ferrari, Moira Marizzoni, Fabiana Faustini, Giulia Oliosi, and Sabina Moro for valuable contributions to the preparation of the manuscript.

Disclosures: No author or immediate family member has financial relationships with commercial organizations that might appear to represent conflicts of interest with the material presented here.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Jessica Dagani
    • 1
  • Ross J. Baldessarini
    • 2
    • 3
  • Giulia Signorini
    • 1
  • Olav Nielssen
    • 4
    • 5
    • 6
  • Giovanni de Girolamo
    • 1
    Email author
  • Matthew Large
    • 5
    • 7
  1. 1.Unit of Psychiatric Epidemiology and EvaluationIRCCS St John of God Clinical Research CenterBresciaItaly
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.International Consortium for Bipolar and Psychotic Disorder Research, Mailman Research Center, McLean HospitalBelmontUSA
  4. 4.Macquarie UniversitySydneyAustralia
  5. 5.School of PsychiatryUniversity of New South WalesSydneyAustralia
  6. 6.St Vincents HospitalSydneyAustralia
  7. 7.Prince of Wales Hospital SydneySydneyAustralia

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