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Age of Onset of Mental Disorders pp 75–110Cite as

The Age of Onset of Bipolar Disorders

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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.

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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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Authors and Affiliations

  1. Unit of Psychiatric Epidemiology and Evaluation, IRCCS St John of God Clinical Research Center, Brescia, Italy

    Jessica Dagani, Giulia Signorini & Giovanni de Girolamo

  2. Harvard Medical School, Boston, MA, USA

    Ross J. Baldessarini

  3. International Consortium for Bipolar and Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA

    Ross J. Baldessarini

  4. Macquarie University, Sydney, NSW, Australia

    Olav Nielssen

  5. School of Psychiatry, University of New South Wales, Sydney, NSW, Australia

    Olav Nielssen & Matthew Large

  6. St Vincents Hospital, Sydney, NSW, Australia

    Olav Nielssen

  7. Prince of Wales Hospital Sydney, Sydney, NSW, Australia

    Matthew Large

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  1. Jessica Dagani
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  3. Giulia Signorini
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  4. Olav Nielssen
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Correspondence to Giovanni de Girolamo .

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  1. Unit of Psychiatric Epidemiology and Evaluation, IRCCS St John of God Clinical Research Center, Brescia, Italy

    Giovanni de Girolamo

  2. Orygen The National Centre of Excellence, University of Melbourne, Victoria, Australia

    Patrick D. McGorry

  3. Association for the Improvement of Mental Health Programmes, Geneva, Switzerland

    Norman Sartorius

Appendix

Appendix

Table 5.6 Studies of AoO of BD (N = 264)
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Dagani, J., Baldessarini, R.J., Signorini, G., Nielssen, O., de Girolamo, G., Large, M. (2019). The Age of Onset of Bipolar Disorders. In: de Girolamo, G., McGorry, P., Sartorius, N. (eds) Age of Onset of Mental Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-72619-9_5

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