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Factors related to hospitalization in elderly manic patients with early and late‐onset bipolar disorder
Author(s) -
Lehmann Susan W.,
Rabins Peter V.
Publication year - 2006
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1607
Subject(s) - bipolar disorder , medicine , pediatrics , age of onset , bipolar i disorder , psychiatry , retrospective cohort study , mania , lithium (medication) , disease
Objective To identify factors contributing to relapse and hospitalization in elderly patients with bipolar disorder. Method 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 (age 45, n = 35). Results 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). Conclusions 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. Copyright © 2006 John Wiley & Sons, Ltd.