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David Baxter

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Gender influences age of bipolar onset
22 February 2005
Psychiatry Matters

Researchers have found gender differences in the incidence and age at onset of mania and bipolar disorder, with men affected earlier than women.

"Despite clear gender differences in the symptoms and course of bipolar affective disorder, studies investigating age at onset by gender have yielded inconsistent results," note Noel Kennedy, from the Institute of Psychiatry in London, UK, and colleagues.

For their study, published in the American Journal of Psychiatry, the team identified all cases of first-episode psychosis, mania, or hypomania in adults presenting to services in Camberwell, southeast London, between 1965 and 1999.

This included 246 patients who met the criteria for DSM-IV bipolar I disorder, first manic episode, of whom 141 (57%) were female, while the remaining 105 (43%) were male.

The average age at onset of mania was 32.9 years, with onset occurring earlier in men than in women, at an average age of 30 years versus 35 years.

Indeed, almost half of the male patients experienced their first episode of mania by the age of 25 years, and 80% by the age of 35 years. In comparison, only one-third of the female patients had experienced mania by the age of 25 years, and just 64% by the age of 35 years.

Similarly, the onset of bipolar disorder occurred in 56% of men by the age of 25 years and in 83% by the age of 35 years, compared with 37% and 68% of women, respectively.

The researchers note that the incidence of first manic episode peaked in men for the 16 to 25-year age group, whereas for women the incidence was lower in this age group, it was higher throughout the rest of adult life in women than for men.

Further analysis also revealed that childhood antisocial behavior was independently associated with earlier onset of mania and bipolar disorder. This led Kennedy et al to speculate that there may be a "subgroup of early-onset predominantly male bipolar disorder patients with behavioral difficulties."

They explain: "Antisocial behavior in childhood could be a manifestation of neurodevelopmental abnormality or even of early-onset bipolar disorder."

Am J Psychiatry 2005; 162: 257-262
 

Roy H.

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Hello Dr. (and Hi all),

I have'nt been here in a while but intend to be around a little more often. My life has been chaotic, to say the least, in the last 6-12 months. I want to keep this short. My mother is manic-depressive, and I have been having severe depression lately with all the chaos in my life, and I was wondering - I am in my late 20s now - so should I be concerned about any onset of bipolar at this stage, or in the near future, of bipolar disorder?
 
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David Baxter

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Should you worry about it? Not necessarily. The fact that you have a close relative with bipolar disorder or schizophrenia does not necessarily mean that you too will develop that illness. However, it is worth being alert for early signs that you might be developing symptoms so that you can get yourself to a doctor for early diagnosis if they do occur.

To put this in perspective, the risk for schizophrenia is about 1% for the general population. If you have a parent or sibling with schizophrenia, your risk increases - to about 10%. So you still have a 90% chance of NOT developing schizophrenia yourself. If you have a twin with schizophrenia, that risk increases to 50% but even with identical genetic material it's not 100%. I would assume that the statistics for bipolar disorder are similar.

However, what does change more significantly if you have a relative with bipolar disorder or schizophrenia is your risk for anxiety and mood disorders in general. The odds are still in your favor that you will not develop bipolar disorder or schizophrenia, but the probablility is considerably higher that you will develop an anxiety disorder of some sort or major depression at some point in your life.
 

Banned

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However, it is worth being alert for early signs that you might be developing symptoms so that you can get yourself to a doctor for early diagnosis if they do occur.

What would "early" signs be? My depression seems all out of whack lately, and I tend to wonder the same thing about myself...
 

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