Gender by onset age interaction may characterize distinct phenotypic subgroups in bipolar patients

Area of Science:

• Psychiatry
• Neuroscience
• Genetics

Background:

• Bipolar disorder (BD) is a recurrent mental health condition with varied illness trajectories.
• Limited data exist on how gender and age at onset interact to influence BD clinical presentation.

Purpose of the Study:

• To investigate the relationship between age at onset and demographic/illness characteristics in BD patients, stratified by gender.
• To identify distinct phenotypic presentations based on gender and age at illness onset.

Main Methods:

• A cohort of 502 BD patients from Stanford University BD Clinic was analyzed.
• Patients were stratified by gender and categorized into pre-pubertal (<12), peri-pubertal (13-16), and post-pubertal (>17 years) onset age groups.
• Demographic, descriptive, and clinical characteristics, including unfavorable illness features, were compared across groups.

Main Results:

• Females with pre-pubertal and peri-pubertal onset showed significantly higher rates of unfavorable illness characteristics compared to post-pubertal onset.
• Males with pre-pubertal onset had higher rates of some unfavorable illness characteristics compared to post-pubertal onset, but fewer differences were observed between peri-pubertal and post-pubertal onset groups.
• While most demographic and clinical correlates were similar between genders, distinct age-at-onset patterns of unfavorable illness characteristics emerged.

Conclusions:

• Gender and age at onset interact to shape distinct phenotypic presentations of bipolar disorder.
• Earlier onset, particularly in females, is associated with a higher burden of unfavorable illness characteristics.
• Further research is needed to fully elucidate the implications of these gender-by-onset-age interactions for BD phenotyping.