AUTHOR=Orsolini Laura , Menculini Giulia , Tempia Valenta Silvia  , Fiorani Michele , Rocchetti David , Salvi Virginio , Tortorella Alfonso , Volpe Umberto 

TITLE=Depressive and Anxious Temperaments as Predictors of Late Onset Bipolar Disorder? Preliminary Results of a “Real World” Exploratory Study

JOURNAL=Frontiers in Psychiatry

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.836187

DOI=10.3389/fpsyt.2022.836187

ISSN=1664-0640

ABSTRACT=<sec><title>Introduction</title><p>Bipolar disorder (BD) onset typically occurs between 15 and 30 years, being diagnosed under the age of 50 in 90% of cases, named “non-late onset BD” (non-LOBD). However, clinical observation of late-onset BD (LOBD) raised some concern regarding a differential psychopathological pattern, outcomes and treatment, including a specific affective temperament vulnerability. Therefore, an exploratory study in the “real world” was carried out by investigating psychopathological and temperamental features of a psychogeriatric cohort of LOBD and non-LOBD subjects.</p></sec><sec><title>Methods</title><p>A total of 180 patients affected with BD-I, BD-II, and Cyclothymic Disorder were screened in a Mood Disorder Outpatient Service, during the timeframe January 2019-August 2021. Out of 78 enrolled outpatients, 66 (33 non-LOBD, 33 LOBD) were recruited, by the retrospective collection of sociodemographic, cognitive, psychopathological and clinical assessment, including the short-version of the Temperament Evaluation of Memphis, Pisa, and San Diego (TEMPS-M).</p></sec><sec><title>Results</title><p>LOBD is significantly associated with higher rates of BD-II diagnosis (χ<sup>2</sup> = 27.692, <italic>p</italic> &lt; 0.001), depressive episodes (<italic>p</italic> = 0.025), mixed states (<italic>p</italic> = 0.009), predominant depressive and anxious affective temperaments (<italic>p</italic> &lt; 0.001). Non-LOBD is significantly associated with higher endocrinological (χ<sup>2</sup> = 6.988, <italic>p</italic> = 0.008) and metabolic comorbidity (χ<sup>2</sup> = 5.987, <italic>p</italic> = 0.014), a diagnosis of BD-I, manic episodes, and predominant hyperthymic affective temperaments (<italic>p</italic> = 0.001). GDS (<italic>p</italic> &lt; 0.001) and MSRS (<italic>p</italic> = 0.005) scores were significantly higher in LOBD.</p></sec><sec><title>Conclusion</title><p>Further longitudinal studies with larger sample sizes and a control group are needed to determine whether LOBD may represent a distinct psychopathological entity from non-LOBD and evaluate differences (if any) in terms of prognosis and treatment between non-LOBD and LOBD.</p></sec>