Age of onset and course and outcome of bipolar disorder: Findings from the bipolar disorder course and outcome study from India (BiD-CoIN study).

BACKGROUND

There is limited data on subtyping of bipolar disorder (BD) based on age of onset (AOO) from developing countries.

AIM: Accordingly this study aimed to compare the long-term course of bipolar disorder among patients with early onset (onset before 18 years) and later AOO (onset after 18 years).

METHODS

Using the data of the Bipolar Disorder Course and Outcome study from India (BiD-CoIN study), the study sample was divided into two groups and the groups were compared for the course of illness, predominant polarity, cognitive impairment, disability, and insight.

RESULTS

The study shows that compared to BD patients with later AOO, those with early AOO have a higher number of depressive and manic episodes, spend significantly lower time in episodes, have lower level of cognitive impairment, a higher proportion of them have history of relapse due to poor adherence, higher proportion have history of hospitalization, receiving electroconvulsive therapy (ECT), a higher prevalence of unipolar mania, predominant manic polarity, and receive higher mean dose of valproate.

CONCLUSION

To conclude, this study suggests that age of onset of BD has impact on the course of illness in the form of more severe illness.