Numan KONUK, Ozlem CETİNKAYA, Derya IPEKCİOGLU, Mehmet Cem ILNEM, Deniz EKER, Fulya MANER

Clinical Charactheristics of Late Onset Mania

Amaç: Bu çalışmada erken ve geç başlangıçlı iki uçlubozukluk tip I manik dönem tanısı almış hastaların,demografik ve klinik özelliklerinin retrospektif olarak karşılaştırılması amaçlandı. Yöntem: Yatarak tedavi gören iki uçlu bozukluk tip I manikdönem tanısı almış 24 yaşlı hasta (≥65 yaş), kendi içlerinde50 yaş sınır kabul edilerek erken ve geç başlangıçlı olarakiki gruba ayrılmış ve 29 genç hasta (19-55 yaş) ile sosyodemografik özellikler, aile hikayesi, profilaktik tedavi,fiziksel hastalık, klinik belirtiler, hastanede kalış süresi,uygulanan tedavi ve klinik düzelme halleri açısından retrospektif olarak karşılaştırıldı. Bulgular: Gençlerde ve erken başlangıç yaşlı hastalardadaha yüksek aile öyküsü bulunmaktadır. Geç başlangıçyaşlı grupta fiziksel hastalık oranı daha fazla bulunmuştur.Eğitim süresi ile hastalık süresi arasında pozitif bir korelasyon vardır. Fikir uçuşması ve basınçlı konuşmaya genç veerken başlangıçlı yaşlı hastalarda daha yüksek oranda rastlanmıştır. Gençlerde daha çok erotomanik tipte, yaşlılardaise perseküsyon tipinde hezeyanlara daha sık rastlanmıştır.Tedavide yaşlı hastalarda daha çok valproat tercih edilmişve geç başlangıçlı yaşlılarda erken başlangıçlı yaşlılaragöre daha fazla antipsikotik kullanılmıştır. Hastanede kalışsüresi yaşlı hasta grubunda daha uzundu. Sonuç: Bulgularımız geç başlangıçlı maninin klinik görünüm, semptom profili, aile öyküsü, eşlik eden fizikselhastalık oranı, hastanede kalış süresi ve tedaviye yanıtgibi özellikler açısından, erken başlangıçlı maniye görefarklılıkları olduğunu göstermektedir. Fakat geç başlangıçlımani alanında yapılan çalışmalarda göz önüne alındığında,bu tablonun farklı bir klinik alt tip olduğuna dair net birsonuca ulaşmanın şu an için mümkün olmadığı gözükmektedir. Yeterli vaka sayısına sahip, daha ileri çalışmalaraihtiyaç vardır.

Geç başlangıçlı maninin klinik karakteristikleri

Objective: Our aim is to compare demographic andclinical characteristics of patients with early and late-onsetdiagnosed as bipolar disorder type I (BPD-I) manic episoderetrospectively. Method: A total of 24 elderly (≥65 years old) hospitalizedpatients with bipolar disorder were divided into 2 groupsas those with early-onset and late-onset disorder,according to a threshold of 50 years of age, and wereretrospectively compared with 29 young patients (19-55years old) in terms of sociodemographic characteristics,clinical symptoms, family history, prophylactic treatment,co-existing medical conditions, duration of hospitalization,psychiatric treatment, and clinical improvement.Results: A positive family history was also more prevalentin young patients and patients with early-onset disease.Co-existing medical conditions were more common inpatients with late-onset disease. A positive correlation wasfound between the duration of education and durationof illness. Flight of ideas and pressured speech weremore commonly observed in young patients and patientswith early-onset disease. While delusions of erotomanictype were more frequent in young patients, persecutiondelusions were more common in elderly patients. In termsof treatment, valproate was preferred in the elderly patientsand antipsychotic medications were more frequently usedin late-onset elderly patients when compared to early- onset elderly patients. The duration of hospitalization waslonger in elderly patients than younger ones. Conclusion: Our findings show that late-onset mania hasdifferent characteristics compared to early-onset maniain terms of clinical characteristics, symptom profile,family history, co-existing medical diseases, duration ofhospitalization, and response to treatment. However, itis hard to conclude that it as a different clinical subgroupwhen previous studies about late-onset mania are takeninto consideration. Further studies with adequate samplesizes are needed.

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