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[The late-onset rapid cycling affective disorder]
1Department of Neuropsychiatry, Kurume University, School of Medicine.
Summary
Few elderly patients over sixty experience rapid cycling affective disorder, with most showing stable depressive episodes. A case study highlighted significant polysomnography and temperature changes across bipolar disorder phases.
Area of Science:
- Geriatric Psychiatry
- Neuroscience
- Sleep Medicine
Background:
- Investigating the prevalence of rapid cycling affective disorder in elderly depressive outpatients.
- Assessing diagnostic criteria adherence in older adults with mood disorders.
Observation:
- Analysis of 166 depressive outpatients over sixty years old.
- Evaluation against Dunner's criteria for rapid cycling (≥4 episodes/year).
- Detailed case study of a 71-year-old female with bipolar disorder, including polysomnography and rectal temperature monitoring.
Findings:
- Only 1.8% of patients met Dunner's criteria for rapid cycling.
- Two out of eight diagnosed with manic-depressive illness met the criteria.
- Most elderly patients exhibited stable depressive states over one year.
- The case study revealed significant physiological changes (polysomnography, rectal temperature) correlating with manic, depressive, and remissional phases.
Implications:
- Rapid cycling affective disorder is uncommon in the elderly population studied.
- Bipolar disorder in older adults may present with stable episodes, challenging diagnosis.
- Physiological monitoring (sleep, temperature) can offer insights into mood state fluctuations in elderly bipolar patients.