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Some evidence suggests that the incidence of bipolar affective disorder (manic-depressive illness) decreases with age. Previous studies have reported an average age of onset in the second decade of life and that the disease rare occurs after age 60. There have been studies, however, that have reported contradictory results. In an effort to replicate findings that many elderly patients have a significant incidence of the disease, 75 elderly inpatients with bipolar affective disorder were identified and records were reviewed for age of onset of the first symptoms of their illness. There were 52 women and 23 men in this sample, all over 60 years of age. The average age of onset of first symptoms was age 46.5 years; for men the average age was 52.7 years and for women 43.7 years. Very few subjects showed evidence of symptoms prior to age 40. In 13 subjects, head injury preceded the first manic episode; for this group, a family history of mental illness was less common than for those who did not have a history of head injury. In general, bipolar illness is thought to correlate with a family history of mental illness. These results support research that suggests the incidence of onset of bipolar illness in old age may be under-recognized. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychiatric hospitals and clinics in the UK are required to submit information about in-patients to the Department of Health, including diagnosis, age, and sex. Diagnoses are based on criteria from the latest edition of the World Health Organization's International Classification of Diseases (ICD-9). The number of first admissions by age and sex for the ICD-9 category of manic-depressive psychosis, manic type between 1982 and 1986 was computed to determine if there were any sex-related differences in the age of onset. The ICD-9 places manic-depressive psychosis, manic type under the category of affective (mood) psychoses. The disorder is characterized by states of elation or excitement out of keeping with the patient's circumstances, and varies from hypomania (enhanced liveliness) to violent and uncontrollable excitement, with a susceptibility to aggression and anger, distractibility, grandiose ideas, and impaired judgment. Previous studies of sex differences in manic-depressive disorder found that more women than men were affected. Analysis of the data in this study demonstrated that between the ages of 10 to 29 years, the rate of onset was nearly equal between the sexes. From age 30 through age 54, females had a notably higher inception rate than males. However, when the overall population age distribution of men and women was taken into account, there was no difference found in the rate of bipolar affective disorder between the sexes. (Consumer Summary produced by Reliance Medical Information, Inc.)