Age of Onset of Bipolar Disorder: a Systematic Review and Meta-Analysis
Poster B12, Tuesday, October%209, 11:30%20am%20-%201:00%20pm, Essex%20Ballroom
Giulia Signorini1, Jessica Dagani1, Ross J Baldessarini2, Olav Nielssen3, Matthew Large4, Giovanni de Girolamo1; 1Saint John of God Clinical Research Centre, Brescia, Italy, 2Harvard Medical School; International Consortium for Bipolar & Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Boston, Massachusetts, USA, 3St Vincent’s Hospital Sydney, University of Sydney, University of New South Wales, NSW, Australia, 4School of Psychiatry , University of New South Wales, NSW, Australia
Objective: As many studies of age of onset (AOO) of bipolar disorder (BD) have been reported but not synthesized, we carried out a systematic review and meta-analysis of this large research literature. Method: We analyze findings from literature searches of the PubMed, Web of Science and Psychology & Behavioral Sciences Collection databases, from their inception through 31 July 2014. Pooled estimates the AOO of BD were calculated by random-effects, meta-analytic modeling, and factors were investigated for influence on between-study heterogeneity with subgroup and meta-regression analyses. Results: Of 8,735 initially identified reports, 252 met inclusion criteria, and represented 68,471 individuals. The overall, pooled average was 25.8 years (95% Confidence Interval [CI]: 25.2–26.3) with high inter-study heterogeneity. There were marked differences in the pooled AOO between countries (Hungary, 19.9, to Croatia, 45.0 years) and world regions (UK 22.0, to East Asia 29.3 years). Mean age, gender, study design, method of estimating AOO, polarity of first-lifetime episode and family history of mood disorder had no association with reported AOO. BD-II did not have older onset than BD-I, even in 14 studies with both diagnoses evaluated under matched conditions. Conclusions: The findings support expectation that most patients diagnosed with BD have their AOO between ages 15 and 30 years. At variance with some primary research, family history and BD-I diagnosis were not associated with younger AOO. Our study suggests that there might be genuine differences in the age of onset on bipolar disorder across geographic regions but it does explain these differences.
Topic Area: Mood Disorders