후기 발생 조증 환자의 정신병리와 임상적 특징: 후향적 의무기록 조사 연구
Psychopathologies and clinical characteristics of late onset manic episode: A retrospective chart review study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: Although there have been many studies suggested that bimodality in age of onset of bipolar disorder could present different clinical characteristics between early- and late- onset manic episodes, it is still difficult to conclude with consistency of the clinical characteristics of late onset manic episodes. The aim of this study is to define the clinical characteristics of late-onset manic episode, comparing early - onset manic episode. Methods: The study subjects included patients admitted to the department of psychiatry, who met DSM-IV-TR criteria for bipolar I disorder, manic episode. The medical records were reviewed retrospectively by two psychiatrists. Subjects who had the first onset of manic episode under the age of 25 were grouped as the early onset group, whereas those who had the first onset of manic episode after the age of 50 were grouped as the late onset group. . The clinical characteristics and psychopathologies between two groups were analyzed with Chi-square test, t-test, Mann-Whitney test. Results: The late onset group had greater medical and neurological comorbidities, shorter mean length of hospital stay and less Young mania rating scale scores. The severity of Elevated mood, Sexual interest, and Disruptive/Aggressive behavior of Young mania rating scale were lower in the late onset group than those of the early onset group. Conclusions: This study suggests that the severity of manic episode in the late onset group is milder than that in the early onset group and there are differences in the clinical characteristics among different age onset groups.
Abstract
Objectives: Although there have been many studies suggested that bimodality in age of onset of bipolar disorder could present different clinical characteristics between early- and late- onset manic episodes, it is still difficult to conclude with consistency of the clinical characteristics of late onset manic episodes. The aim of this study is to define the clinical characteristics of late-onset manic episode, comparing early - onset manic episode. Methods: The study subjects included patients admitted to the department of psychiatry, who met DSM-IV-TR criteria for bipolar I disorder, manic episode. The medical records were reviewed retrospectively by two psychiatrists. Subjects who had the first onset of manic episode under the age of 25 were grouped as the early onset group, whereas those who had the first onset of manic episode after the age of 50 were grouped as the late onset group. . The clinical characteristics and psychopathologies between two groups were analyzed with Chi-square test, t-test, Mann-Whitney test. Results: The late onset group had greater medical and neurological comorbidities, shorter mean length of hospital stay and less Young mania rating scale scores. The severity of Elevated mood, Sexual interest, and Disruptive/Aggressive behavior of Young mania rating scale were lower in the late onset group than those of the early onset group. Conclusions: This study suggests that the severity of manic episode in the late onset group is milder than that in the early onset group and there are differences in the clinical characteristics among different age onset groups.
참고문헌 (23)
- Summers WK, "Mania with onset in the eighth decade:two cases and a review", J Clin Psychiatry, 44, pp.141~143 (1983)
- Walter-Ryan WG, "Mania with onset in the ninth decade", J Clin Psychiatry, 44, pp.430~431 (1983)
- Benjamin J, "Kaplan and Sadock’s Comprehensive textbook of psychiatry. Vol1", pp.1645~1652 (2009), Lippincott Williams & Wilkins
- Almeida OP, "Bipolar disorder: similarities and differences between patients with illness onset before and after 65 years of age", Int Psychogeriatr, 14, pp.311~322 (2002)
- Kennedy N, "Incidence and distribution of first-episode mania by age: results from a 35-year study", Psychol Med, 35, pp.855~863 (2005)
- Tohen M, "First-episode mania in late life", Am J Psychiatry, 151, pp.130~132 (1994)
- Depp CA, "Bipolar disorder in older adults : a critical review", Bipolar Disord, 6, pp.343~367 (2004)
- Schurhoff F, "Early and late onset bipolar disorders: two different forms of manic-depressive illness?", J Affect Disord, 58, pp.215~221 (2000)
- 나경세, "양극성 장애에서 발병 연령에 따른 증상 및 예후의 차이 : 전향적 1년 추적 연구", 신경정신의학, 46(2), pp.122~128 (2007), 대한신경정신의학회
- Wylie ME, "Effects on clinical presentation and treatment outcomes in an inpatient sample", Am J Geriatr Psychiatry, 7, pp.77~83 (1999)
- Yong RC, "Age, manic psychopathology and treatment response", Int J Geriatr Psychiatry, 4, pp.73~78 (1989)
- Van Gerpen MW, "Mania in the geriatric patient population: a review of the literature", Am J Geriatr Psychiatry, 7, pp.188~202 (1999)
- Young RC, "A rating scale for mania: reliability, validity and sensitivity", Br J Psychiatry, 133, pp.429~435 (1978)
- 정희연, "Young조증 평가 척도의 한국판 표준화 연구", 신경정신의학, 42(2) (2003), 대한신경정신의학회
- Overall JE, "The brief psychiatric rating scale", Psychological Reports, 10, pp.799~812 (1962)
- Shulman KI, "Mania compared with unipolar depression in old age", Am J Psychiatry, 149, pp.341~345 (1992)
- "뇌졸중 유병률 추이: 성별, 만50세 이상" (2013)[URL]
- Slater E, "Clinical Psychiatry", pp.571~572 (1977), Tindall & Cassell
- Beller SA, "The Brief Psychiatric Rating Scale (BPRS) in geropsychiatric research: II. Representative profile patterns", J Gerontol, 39, pp.194~200 (1984)
- Sajatovic M, "New-onset bipolar disorder in later life", Am J Geriatr Psychiatry, 13, pp.282~289 (2005)
- McGlashan TH, "Adolescent versus adult onset of mania", Am J Psychiatry, 145, pp.221~223 (1988)
- Carlson GA, "Phenomenology and outcome of subjects with early- and adult-onset psychotic mania", Am J Psychiatry, 157, pp.213~219 (2000)
- Strober M, "A family study of bipolar I disorder in adolescence. Early onset of symptoms linked to increased familial loading and lithium resistance", J Affect Disord, 15, pp.255~268 (1988)