Related Experiment Video
Updated: Apr 21, 2026

Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
The impact of age at onset of bipolar I disorder on functioning and clinical presentation
Frances Biffin1, Steven Tahtalian1, Kate Filia1
11Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychology, Psychiatry & Psychological Medicine, Commercial Road, Melbourne Australia.
Objectives:
Recent studies have proposed the existence of three distinct subgroups of bipolar 1 disorder based on age at onset (AAO). The present study aims to investigate potential clinical and functional differences between these subgroups in an Australian sample.
Methods:
Participants (n = 239) were enrolled in the Bipolar Comprehensive Outcomes Study (BCOS), a 2-year longitudinal, observational, cross-sectional study. Assessment measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD21), Clinical Global Impressions Scale (CGI-BP), SF-36, SLICE/Life Scale, and the EuroQol (EQ-5D). Participants were also asked about their age at the first major affective episode.
Results:
Three AAO groups were compared: early (AAO < 20, mean = 15.5 ± 2.72; 44.4% of the participants); intermediate (AAO 20-39, mean = 26.1 ± 4.8; 48.14% of the participants) and late (AAO > 40, mean = 50.6 ± 9.04; 7.4% of the participants). Higher rates of depression, suicidal ideation and binge drinking were reported by the early AAO group. This group also reported poorer quality of life in a number of areas. The early AAO group had a predominant depressive initial polarity and the intermediate group had a manic predominance.
Conclusion:
Early AAO is associated with an adverse outcome.
Related Concept Videos
Bipolar Disorder
Mania and Antimanic Drugs: Overview
Schizophrenia
Borderline Personality Disorder
Genetic and Environmental Contributions
Borderline Personality...
Psychosis: Goals of Pharmacotherapy
Alzheimer Disease l: Introduction

