Although bipo
lar disorder (BD) is
a common recurrent condition with high
ly heterogeneous i
llness course, d
at
a are
limited reg
arding c
linic
al imp
lic
ations of inter
actions between gender
and onset
age. We
assessed re
lationships between onset
age
and demogr
aphic/i
llness ch
ar
acteristics
among BD p
atients str
atified by gender.
absSec_2">Methods
abspara0015">Demographic and unfavorable illness characteristics, descriptive traits, and clinical correlates were compared in 502 patients from Stanford University BD Clinic patients enrolled in the Systematic Treatment Enhancement Program for BD between 2000 and 2011, stratified by gender, across pre-, peri-, and post-pubertal (<12, 13–16, and >17 years, respectively) onset-age subgroups.
absSec_3">Results
abspara0020">Among 502 BD patients, 58.2% were female, of whom 21.9% had pre-pubertal, 30.7% peri-pubertal, and 47.4% post-pubertal onset. Between genders, although demographics, descriptive characteristics, and most clinical correlates were statistically similar, there were distinctive onset-age related patterns of unfavorable illness characteristics. Among females, rates of 6/8 primary unfavorable illness characteristics were significantly higher in pre-pubertal and peri-pubertal compared to post-pubertal onset patients. However, among males, rates of only 3/8 unfavorable illness characteristics were significantly higher in only pre-pubertal versus post-pubertal onset patients, and none between peri-pubertal versus post-pubertal onset patients.
absSec_4">Limitations
abspara0025">Caucasian, insured, suburban, American specialty clinic-referred sample limits generalizability, onset age based on retrospective recall.
absSec_5">Discussion
abspara0030">We describe different phenotypic presentations across age at illness onset groups according to gender. Among females and males, peri-pubertal and post-pubertal onset age groups were more different and more similar, respectively. Further investigation is warranted to assess implications of gender-by-onset-age interactions to more accurately delineate distinctive BD phenotypes.