Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- 1 Bipolar disorders beyond major depression and euphoric mania
- 2 Emerging concepts of mixed states: a longitudinal perspective
- 3 Rapid-cycling bipolar disorder
- 4 Bipolar I and bipolar II: a dichotomy?
- 5 Recurrent brief depression as an indicator of severe mood disorders
- 6 Atypical depression and its relation to bipolar spectrum
- 7 Agitated depression: spontaneous and induced
- 8 Schizoaffective mixed states
- 9 Acute and transient psychotic disorder: an atypical bipolar disorder?
- 10 Bipolar disorder in children and adolescents
- 11 Atypical features of bipolarity in old age
- 12 Comorbidity in mixed states and rapid-cycling forms of bipolar disorders
- 13 Challenges in the genetics of bipolar disorder
- 14 Biological aspects of rapid-cycling and mixed states
- 15 The treatment of bipolar mixed states
- 16 The use of atypical antipsychotic agents in the treatment of diagnostic subgroups of bipolar disorder: mixed and pure states, psychotic and non-psychotic
- 17 Investigational strategies: treatment of rapid cycling, mixed episodes, and atypical bipolar mood disorder
- Index
- References
11 - Atypical features of bipolarity in old age
Published online by Cambridge University Press: 10 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface
- 1 Bipolar disorders beyond major depression and euphoric mania
- 2 Emerging concepts of mixed states: a longitudinal perspective
- 3 Rapid-cycling bipolar disorder
- 4 Bipolar I and bipolar II: a dichotomy?
- 5 Recurrent brief depression as an indicator of severe mood disorders
- 6 Atypical depression and its relation to bipolar spectrum
- 7 Agitated depression: spontaneous and induced
- 8 Schizoaffective mixed states
- 9 Acute and transient psychotic disorder: an atypical bipolar disorder?
- 10 Bipolar disorder in children and adolescents
- 11 Atypical features of bipolarity in old age
- 12 Comorbidity in mixed states and rapid-cycling forms of bipolar disorders
- 13 Challenges in the genetics of bipolar disorder
- 14 Biological aspects of rapid-cycling and mixed states
- 15 The treatment of bipolar mixed states
- 16 The use of atypical antipsychotic agents in the treatment of diagnostic subgroups of bipolar disorder: mixed and pure states, psychotic and non-psychotic
- 17 Investigational strategies: treatment of rapid cycling, mixed episodes, and atypical bipolar mood disorder
- Index
- References
Summary
Introduction
Studying an elderly cohort confers several special advantages compared to younger or mixed-age populations. In the first instance, one has available a lifelong clinical course that has already unfolded. This allows for tracking of age of onset and describing long-term clinical patterns in a way that is much more practical than extensive prospective studies of younger patients. Second, genetic patterns of inheritance can be more fully explored as the exposure in first-degree relatives, especially children and siblings, will be much longer than in studies of younger probands. Third, an elderly cohort offers the opportunity to study lesions of the brain, thus casting more light on localization and pathogenesis, which can be extrapolated back to potential neurophysiological patterns in younger bipolars. Finally, outcome studies of the elderly can reveal differential rates of mortality and psychosocial vulnerability which can be compared to controls, other mood disorders, and neuropsychiatric conditions of late life.
Atypical features
These special aspects of study in the elderly result in features of bipolarity which are quite different from the usual cohorts of bipolar disorder whose mean age of onset is in the early 20s (Weissman et al., 1991). Not surprisingly, atypical features described in this chapter will include:
late age of onset
prolonged latency from first depression to first mania
high prevalence of neurologic comorbidity
presence of cognitive impairment
poor outcome characterized by increased mortality and finally increased nosologic confusion related to the presence of neurologic comorbidity and the similarity of secondary mania to other neurological conditions with disinhibition syndromes (Shulman, 1997)
Keywords
- Type
- Chapter
- Information
- Bipolar DisordersMixed States, Rapid Cycling and Atypical Forms, pp. 252 - 262Publisher: Cambridge University PressPrint publication year: 2005
References
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