Late-life bipolar depression due to the soft form of bipolar disorder compared to unipolar depression: An inpatient chart review study

Takeshima, Minoru; Kurata, Kouichi

doi:10.1016/j.jad.2009.07.019

Cited by 10 publications

(5 citation statements)

References 38 publications

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“…Six studies reported the relative proportion of older adults with mania in inpatient psychiatric settings . All studies were retrospective chart reviews.…”

Section: Resultsmentioning

confidence: 99%

The prevalence of late‐life mania: a review

Dols¹,

Kupka

Lammeren³

et al. 2013

Bipolar Disorders

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Late-life mania is not rare in older psychiatric inpatients and late-onset mania is associated with increased somatic comorbidity in patients aged 50 years and older. Several hypotheses regarding the relationship between somatic illness and late-life mania in the elderly have been proposed and studies on this relationship and the prevalence of late-life mania in different senior psychiatric care facilities deserve specific attention in future research projects.

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“…Six studies reported the relative proportion of older adults with mania in inpatient psychiatric settings . All studies were retrospective chart reviews.…”

Section: Resultsmentioning

confidence: 99%

The prevalence of late‐life mania: a review

Dols¹,

Kupka

Lammeren³

et al. 2013

Bipolar Disorders

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“…Therefore, it is necessary to ask patients and their significant others about any history of manic/hypomanic episodes when examining elderly patients with MDE. Elderly patients with bipolar II disorder/BD not otherwise specified show significantly higher prevalence of early onset of first MDE (<60 years), frequent MDEs (>3), and depressive mixed state (mixed depression) than those with MDD 4 . These features could help to differentiate BD and MDD.…”

Section: Section a Considerations Before Introduction Of Treatmentmentioning

confidence: 99%

“…Elderly patients with bipolar II disorder/BD not otherwise specified show significantly higher prevalence of early onset of first MDE (<60 years), frequent MDEs (>3), and depressive mixed state (mixed depression) than those with MDD. 4 These features could help to differentiate BD and MDD.…”

Section: Section a Considerations Before Introduction Of Treatment Di...mentioning

confidence: 99%

Guidelines for diagnosis and treatment of depression in older adults: A report from the Japanese Society of mood disorders

Baba

Kito

Nukariya

et al. 2022

Psychiatry Clin Neurosci

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The Committee for Treatment Guidelines of Mood Disorders, Japanese Society of Mood Disorders, published a Japanese guideline for the treatment of late‐life depression in 2020. Based on that guideline, the present guideline was developed and revised to incorporate the suggestions of global experts and the latest published evidence. In the diagnosis of late‐life depression, it is important to carefully differentiate it from bipolar disorders, depressive states caused by physical and organic brain disease, drug effects, and dementia, and to determine the comorbidity between late‐life depression and dementia. It is necessary to fully understand the clinical characteristics and psychosocial background of late‐life depression, evaluate the patient's condition, and provide basic interventions based on these factors. Problem‐solving therapy, reminiscence therapy/life review therapy, and behavioral activation therapy, and other forms of psychotherapy can reduce depressive symptoms. In terms of pharmacotherapy, newer antidepressants or non‐tricyclic antidepressants are recommended for late‐life depression, and it is recommended that the efficacy of least the minimal effective dosage should first be determined. Switching antidepressants and aripiprazole augmentation can be used to treatment‐resistant therapy. Electroconvulsive therapy and repetitive transcranial magnetic stimulation have demonstrated usefulness for late‐life depression. Exercise therapy, high‐intensity light therapy, and diet therapy also show some effectiveness and are useful for late‐life depression. Continuation therapy should be maintained for at least 1 year after remission.

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“…For instance, a retrospective study found that the misdiagnosis rate was 73% in older patients with BD-type II (BD-II) or bipolar disorder not otherwise specified (BD-NOS) and 34% in those with BD-type I (BD-I), with the most frequent misdiagnosis being major depressive disorder (MDD). 6 The misdiagnosis of BD may result in a range of negative health outcomes, such as delayed or inappropriate treatment 7,8 (e.g. prolonged treatment with antidepressants and delayed introduction of mood stabilizers), which could increase the risk of rapid cycling, [9][10][11] leading to poor treatment response, impaired cognitive and social functioning, and even increased suicide risk.…”

Section: Introductionmentioning

confidence: 99%

Use of the 33-Item Hypomania Checklist (HCL-33) to Distinguish Bipolar Disorder From Major Depressive Disorder in Older Adults

Zhang

Zhao

et al. 2021

J Geriatr Psychiatry Neurol

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Background: Bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD) in older patients. This study examined the psychometric properties of the 33-item Hypomania Checklist (HCL-33) and its accuracy to differentiate BD from MDD among older adults. Method: A total of 215 depressed older patients were recruited; 107 were diagnosed with BD (71 with BD-type I and 36 with BD-type II) and 108 with MDD. Principal components analysis (PCA) was used to explore the factor structure of the HCL-33. Cronbach’s alpha was calculated to test the internal consistency. Intra-class correlation coefficient (ICC) was used to measure test-retest reliability. The receiver operating characteristic (ROC) analysis was used to generate the optimal cut-off value to differentiate between BD and MDD. Results: Two factors were identified in the PCA analysis accounting for 33.9% of the total variance. The Cronbach’s alpha value for the HCL-33 was 0.912, with 0.922 for factor I and 0.664 for factor II. The test-retest reliability was excellent (ICC: 0.891). The optimal cut-off of the HCL-33 total score for discriminating between MDD and BD was 14, with a sensitivity of 88.8% and specificity of 82.4%. Conclusion: The HCL-33 had satisfactory reliability and validity and could be used to distinguish BD from MDD in older adults.

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Late-life bipolar depression due to the soft form of bipolar disorder compared to unipolar depression: An inpatient chart review study

Cited by 10 publications

References 38 publications

The prevalence of late‐life mania: a review

The prevalence of late‐life mania: a review

Guidelines for diagnosis and treatment of depression in older adults: A report from the Japanese Society of mood disorders

Use of the 33-Item Hypomania Checklist (HCL-33) to Distinguish Bipolar Disorder From Major Depressive Disorder in Older Adults

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