The prevalence of bipolar spectrum disorder in elderly patients with recurrent depression
Chang-In Lee,1 Young-Eun Jung,1 Moon-Doo Kim,1 Seong-Chul Hong,2 Won-Myong Bahk,3 Bo-Hyun Yoon4
1Department of Psychiatry, 2Department of Preventive Medicine, School of Medicine, Jeju National University, Jeju, Republic of Korea; 3Department of Psychiatry, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 4Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea
Purpose: Despite a growing body of knowledge on bipolar spectrum disorder (BSD), relatively little is known about the clinical characteristics of BSD in elderly people. We investigated the prevalence of BSD in elderly patients with recurrent depression.
Patients and methods: A total of 65 elderly outpatients (≥60 years of age) who met the Diagnostic and Statistical Manual of Mental Disorders IV criteria for recurrent major depressive disorder participated in the study. BSD was diagnosed according to the criteria developed by Ghaemi et al and the Mood Disorder Questionnaire (MDQ) was used to assess bipolarity.
Results: Of 65 subjects, eleven (16.9%) and 54 (83.1%) were diagnosed with BSD and unipolar depression, respectively. A total of 32.3% (n=22) had a positive screen for bipolar disorder, and we found a significant association between the BSD criteria and the criteria for a positive MDQ (P<0.001). Patients with BSD had a longer duration of illness (P=0.040) and more prior depressive episodes (P<0.001) than did those with unipolar depression. The BSD criteria of first-degree relative with bipolar disorder (P=0.030), antidepressant-induced hypomania (P=0.034), hyperthymic personality (P=0.001), and atypical depression (P=0.030) were highly associated with MDQ-positive patients.
Conclusion: Our results indicate that many depressed elderly patients have bipolar-related illness; moreover, some features of the depression are associated with bipolarity.
Keywords: bipolarity, unipolar depression, MDQ, elderly
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