Bipolar disorder in older adults: A critical review

Bipolar Disorders

Volumn 6, Issue 5, 2004, Pages 343-367

  Depp, Colin A ^a   Jeste, Dilip V ^a,b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b VA SAN DIEGO HEALTHCARE SYSTEM   (United States)

Author keywords

Aging; Bipolar disorder; Elderly; Mania

Indexed keywords

ADULT; AGED; BIPOLAR DISORDER; CLINICAL FEATURE; COMORBIDITY; CONTROLLED STUDY; DATA ANALYSIS; DISEASE COURSE; FAMILY HISTORY; FEMALE; HEALTH CARE UTILIZATION; HOSPITAL ADMISSION; HOSPITAL PATIENT; HUMAN; LIFESPAN; LINGUISTICS; LONGITUDINAL STUDY; MALE; MANIA; MEDICAL RECORD; MEDICAL RESEARCH; MEDLINE; MENTAL HEALTH SERVICE; MENTAL HOSPITAL; METHODOLOGY; NEUROPSYCHOLOGY; ONSET AGE; PREVALENCE; PRIORITY JOURNAL; PSYCINFO; PUBLISHING; REVIEW; SAMPLE SIZE;

AGED; BIPOLAR DISORDER; CARDIOVASCULAR DISEASES; COMORBIDITY; DEMENTIA; DEPRESSION; DIABETES MELLITUS, TYPE 2; HOSPITALIZATION; HUMANS; MENTAL HEALTH SERVICES; MIDDLE AGED; NEUROPSYCHOLOGICAL TESTS; PREVALENCE;

EID: 5144231651     PISSN: 13985647     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1399-5618.2004.00139.x     Document Type: Review

References (150)

1. Jeste D, Alexopoulos GS, Bartels SJ et al. Consensus statement on the upcoming crisis in geriatric mental health: research agenda for the next 2 decades. Arch Gen Psychiatry 1999; 56: 848-853.
2. Charney D, Reynolds C, Lewsi L et al. Depression and bipolar support alliance consensus on the unmet needs in diagnosis and treatment of mood disorders in late life. Arch Gen Psychiatry 2003; 60: 664-672.
3. Cassano G, McElroy S, Brady K, Nolen W, Placidi G. Current issues in the identification and management of bipolar spectrum disorders in 'special populations'. J Affect Disord 2000; 59: S69-S79.
4. Goodwin F, Jamison K. Manic-Depressive Illness. Oxford: Oxford University Press, 1990.
5. Koenig H, Blazer D. Epidemiology of geriatric affective disorders. Clin Geriatr Med 1992; 8: 234-251.
6. Addonizoio G, Alexopoulos G. Affective disorders in the elderly. Int J Geriatr Psychiatry 1993; 8: 41-47.
7. Reynolds CR, Frank E, Perel J, Mazumdar S, Kupfer D. Maintenance therapies for late-life recurrent major depression: research and review circa 1995. Int Psychogeriatr 1995; 7: 27-39.
8. Unutzer J, Bruce M, Workgroup NAD. The elderly. Ment Health Serv Res 2002; 4: 245-247.
9. Kraepelin E. Manic-Depressive insanity and paranoia. Chicago: University of Chicago Press, 1921.
10. Winokur G, Clayton P, Reich T. Manic-Depressive Illness. St Louis, MO: Mosby, 1969.
11. Post R, Rubinow D, Ballenger J. Conditioning and sensitization in the longitudinal course of affective illness. Br J Psychiatry 1986; 149: 191-201.
12. Rennie T. Prognosis in manic-depressive illness. Am J Psychiatry 1942; 98: 801-814.
13. Blazer D, Koenig H. Mood disorders. In: Blazer EBD ed. Textbook of Geriatric Psychiatry. Washington, DC: American Psychiatric Association Press, 1996.
14. Post F. The Clinical Psychiatry of Late Life. Oxford: Pergamon, 1965.
15. Roth M. The natural history of mental disorder in old age. J Ment Sci 1955; 101: 281-301.
16. King D, Markus H. Mood disorders in older adults. In: Whitbourne S ed. Psychopathology in Later Adulthood. New York: Wiley & Sons, 2000.
17. Post F. Affective disorders in old age. In: Paykel E ed. Handbook of Affective Disorders. New York: Guilford Press, 1982.
18. Shulman K, Hermann N. The nature and management of mania in old age. Psychiatr Clin North America 1999; 22: 649-665.
19. Shulman K. Disinhibition syndromes, secondary mania and bipolar disorder in old age. J Affect Disord 1997; 46: 175-182.
20. DeAsis J, Lei X, Young RC. Biological factors in bipolar disorders in late life. In: Soares J, Gershon S eds. Bipolar Disorders: Basic Mechanisms and Therapeutic Implications. New York: Marcel Dekker, 2000.
21. Umpathy C, Mulsant B, Pollock B. Bipolar disorder in the elderly. Psychiatr Annal 2000; 30: 473-480.
22. Sajatovic M. Treatment of bipolar disorder in older adults. Int J Geriatr Psychiatry 2002; 17: 865-873.
23. Sajatovic M. Aging-related issues in bipolar disorder: a health services perspective. J Geriatr Psychiatry Neurol 2002; 15: 128-133.
24. Sproule B, Hardy B, Shulman K. Differential pharmacokinetics of lithium in elderly patients. Drugs Aging 2000; 16: 165-177.
25. Young RC, Gyulai L, Mulsant BH, Flint A, Beyer JL, Shulman KI, Reynolds CF. Pharmacotherapy of bipolar in old age: review and recommendations. Am J Geriatr Psychiatry 2004; 12: 342-357.
26. McDonald W. Epidemiology, etiology, and treatment of geriatric mania. J Clin Psychiatry 2000; 13(Suppl.): 3-11.
27. McDonald W, Nemeroff C. The diagnosis and treatment of mania in the elderly. Bull Menninger Clin 1996; 60: 174-196.
28. Eastham J, Jeste DV, Young R. Assessment and treatment of bipolar disorder in the elderly. Drugs Aging 1998; 12: 205-224.
29. Schulman K, Mackenzie S, Hardy B. The clinical use of lithium carbonate in old age: a review. Prog Neuropsychopharmacol Biol Psychiatry 1987; 11: 159-164.
30. Chen S, Altshuler L, Spar J. Bipolar disorder in late life: a review. J Geriatr Psychiatry Neurol 1998; 11: 29-45.
31. Young R. Bipolar mood disorders in the elderly. Psychiatr Clin North America 1997; 20: 121-137.
32. Young R, Klerman G. Mania in late life: focus on age at onset. Am J Psychiatry 1992; 149: 867-876.
33. Van Gerpen M, Johnson J, Winstead D. Mania in the geriatric patient population. Am J Geriatr Psychiatry 1999; 7: 188-202.
34. McDonald W, Wermager J. Pharmacologic treatment of geriatric mania. Curr Psychiatr Rep 2002; 4: 43-50.
35. Meeks S. Bipolar disorder in the latter half of life: symptom presentation, global functioning, and age of onset. J Affect Disord 1999; 52: 161-167.
36. Benazzi F. Bipolar II depression in late life: prevalence and clinical features in 525 depressed outpatients. J Affect Disord 2001; 66: 13-18.
37. Hazzard W, Blass J, Halter J, Ouslander J, Tinetti M. Principles of Geriatric Medicine and Gerontology, 5th edn. New York: McGraw-Hill, 2003.
38. Broadhead J, Jacoby R. Mania in old age: a first prospective study. Int J Geriatr Psychiatry 1990; 5: 215-222.
39. Meeks S, Murrell S. Mental illness in late life: socio-economic conditions, psychiatric symptoms, and adjustment of long-term sufferers. Psychol Aging 1997; 12: 296-308.
40. Dhingra U, Rabins P. Mania in the elderly: a 5-7 year follow-up. J Am Geriatr Soc 1991; 39: 581-583.
41. Wertham F. A group of benign chronic psychoses: prolonged manic excitements. Am J Psychiatry 1929; 86: 17-78.
42. Shulman K, Tohen M, Satlin A, Mallya G, Kalunian D. Mania compared with unipolar depression in old age. Am J Psychiatry 1992; 149: 341-345.
43. Holyrod S, Rabins P. A retrospective chart review of lithium side effects in a geriatric outpatient population. Am J Geriatr Psychiatry 1994; 2: 346-351.
44. Yassa R, Nair V, Nastase C, Camile Y, Belzile L. Prevalence of bipolar disorder in a psychogeriatric population. J Affect Disord 1988; 14: 197-201.
45. Wylie M, Mulsant B, Pollock B et al. Age at onset in geriatric bipolar disorder. Am J Geriatr Psychiatry 1999; 7: 77-83.
46. Glasser M, Rabins P. Mania in the elderly. Age Ageing 1984; 13: 210-213.
47. Stone K. Mania in the elderly. Br J Psychiatry 1989; 155: 220-224.
48. Taylor M, Abrams R. Manic states: a genetic study of early and late onset affective disorders. Arch Gen Psychiatry 1973; 28: 656-658.
49. Almeida O, Fenner S. Bipolar disorder: similarities and differences between patients with illness onset before and after 65 years of age. Int Psychogeriatr 2002; 14: 311-322.
50. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, 9th Revision, Vol. 1. Geneva: WHO, 1977.
51. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. Washington, DC: American Psychiatric Association, 1980.
52. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd edn, Revised. Washington, DC: American Psychiatric Association, 1987.
53. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington DC: American Psychiatric Association, 1994.
54. Spitzer R, Endicott J, Robins E. Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978; 35: 773-782.
55. Shulman K, Post F. Bipolar affective disorder in old age. Br J Psychiatry 1980; 136: 26-32.
56. Bartels S, Forester B, Miles K, Joyce T. Mental health service use by elderly patients with bipolar disorder and unipolar major depression. Am J Geriatr Psychiatry 2000; 8: 160-166.
57. Bartels S, Mueser K, Miles K. A comparative study of elderly patients with schizophrenia and bipolar disorder in nursing homes and the community. Schizophr Res 1997; 27: 181-190.
58. Young RC, Biggs J, Ziegler V, Meyer D. A rating scale for mania: reliability, validity, and sensitivity. Br J Psychiatry 1978; 133: 429-435.
59. Brown E, Rush AJ, Biggs MM, Shores-Wilson K, Carmody TJ. Clinician ratings vs. global ratings of symptom severity: a comparison of symptom measures in the bipolar disorder module, phase II, Texas Medication Algorithm Project. Psychiatry Res 2003; 117: 167-175.
60. Weissman M, Leaf P, Tischler G et al. Affective disorders in five U.S. communities. Psychol Med 1988; 18: 141-153.
61. Hirschfeld R, Calabrese J, Weisman M et al. Screening for bipolar disorder in the community. J Clin Psychiatry 2003; 64: 53-59.
62. Kessler RC, Andrews G, Mroczek D. The World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF). Geneva: World Health Organization, 1998.
63. Klap R, Tschantz K, Unutzer J. Caring for mental illness in the United States. Am J Geriatr Psychiatry 2003; 11: 517-524.
64. Unutzer J, Simon G, Pabiniak C, Bond K, Katon W. The treated prevalence of bipolar disorder in an large staff-model HMO. Psychiatr Serv 1998; 49: 1072-1078.
65. Moak G. Characteristics of demented and non-demented geriatric admissions to a state hospital. Hosp Commun Psychiatry 1990; 41: 799-801.
66. Ettner S, Hermann R. Inpatient psychiatric treatment of elderly Medicare beneficiaries. Psychiatr Serv 1998; 49: 1173-1179.
67. Brown S. Variations in utilization and cost of inpatient psychiatric services among adults in Maryland. Psychiatr Serv 1998; 52: 841-843.
68. Speer D. Differences in social resources and treatment history among diagnostic groups of older adults. Hosp Commun Psychiatry 1992; 43: 270-274.
69. Molinari VCR, Rosenberg S. Bipolar disorder in the elderly. J Psychiatr Treat Eval 1983; 5: 325-330.
70. Holyrod S, Duryee J. Characteristics of persons utilizing a geriatric psychiatry outpatient clinic. J Geriatr Psychiatry Neurol 1997; 10: 136-141.
71. Tariot P, Podgorski C, Blazina L, Leibovici A. Mental disorders in the nursing home: another perspective. Am J Psychiatry 1993; 150: 1063-1069.
72. Shulman K, Marton P, Fisher A, Cohen C. Characteristics of psychogeriatric patient visits to a general hospital emergency room. Can J Psychiatry 1996; 41: 175-180.
73. Wingerson D, Russo J, Ries R, Dagadakis C, Roy-Byrne P. Use of psychiatric emergency services and enrollment status in a public managed mental health care plan. Psychiatr Serv 2001; 52: 1494-1501.
74. Sachs GS, Thase ME, Otto MW et al. Rationale, design, and methods of the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biol Psychiatry 2003; 53: 1028-1042.
75. Post R, Leverich GS, Altshuler LL et al. An overview of recent findings of the Stanley Foundation Bipolar Network (Part I). Bipolar Disord 2003; 5: 310-319.
76. Suppes T, Leverich GS, Keck PE et al. The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients. J Affect Disord 2001; 67: 45-49.
77. Gyulai L. Well-being and Functioning in Bipolar Disorder How Much Do We Know About the Elderly? Eleventh National Congress of the International Psychogeriatrics Association, Chicago, 2003.
78. United States Census Bureau: Profiles of general demographic characteristics. United States Census of Population and Housing, 2003.
79. Keith S, Regier D, Rae D. Schizophrenic disorders. In: Robins L, Regier D eds. Psychiatric Disorders in America: The Epidemiological Catchment Area Study. New York: Free Press, 1991: 33-52.
80. Young RC, Falk J. Age, manic psychopathology, and treatment response. Int J Geriatr Psychiatry 1989; 4: 73-78.
81. Blackburn I, Loudon J, Ashworth C. A new scale for measuring mania. Psychol Med 1977; 7: 453-458.
82. Calabrese J, Hirschfeld R, Reed M et al. Impact of bipolar disorder on a U.S. community sample. J Clin Psychiatry 2003; 64: 425-432.
83. Overall J, Gorham D. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799-812.
84. Molloy D, Alemayehu E, Roberts R. Reliability of a standardized Mini-Mental State Exam compared with the traditional Mini-Mental State Exam. Am J Psychiatry 1991; 148: 102-105.
85. Endicott J, Spitzer R, Fleiss J. The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976; 33: 766-771.
86. Berrios G, Bakshi N. Manic and depressive symptoms in the elderly: their relationships to treatment outcome, cognition, and motor symptoms. Psychopathology 1991; 24: 31-38.
87. Tsuang M, Woolson R, Fleming J. Long-term outcome of major psychoses. Arch Gen Psychiatry 1979; 39: 1295-1301.
88. Carlson G, Davenport Y, Jamison K. A comparison of outcome in adolescent- and late-onset bipolar manic-depressive illness. Am J Psychiatry 1977; 134: 919-922.
89. Rasanen P, Tiihonen J, Hakko H. The incidence and onset-age of hospitalized bipolar affective disorder in Finland. J Affect Disord 1998; 48: 63-68.
90. Eagles J, Whalley L. Ageing and affective disorders: the age at first onset of affective disorders in Scotland 1969-1978. Br J Psychiatry 1985; 147: 180-187.
91. Spicer C, Slater E. Neurotic and psychotic forms of depressive illness: evidence from age-incidence in a national sample. Br J Psychiatry 1978; 123: 535-541.
92. Sibisi C. Sex differences in the age of onset of bipolar affective illness. Br J Psychiatry 1990; 156: 842-845.
93. Schurhoff F, Bellivier F, Jouvent R et al. Early and late onset bipolar disorders: two different forms of manic-depressive illness? J Affect Disord 2000; 58: 215-221.
94. Cassidy F, Carroll B. Vascular risk factors in late onset mania. Psychol Med 2002; 32: 359-362.
95. Beyer J, Kuchibhatia M, Looney C et al. Social support in elderly patients with bipolar disorder. Bipolar Disord 2003; 5: 22-27.
96. Angst J, Preisig M. Course of a clinical cohort of unipolar, bipolar, and schizoaffective patients. Results of a prospective study from 1959 to 1985. Schweiz Arch Neurol Psychiatr 1995; 146: 7-16.
97. Angst J, Preisig M. Outcome of a clinical cohort of unipolar, bipolar, and schizoaffective patients. Results of a prospective study from 1959 to 1985. Schweiz Arch Neurol Psychiatr 1995; 146: 17-23.
98. Snowdon J. A retrospective case note study of bipolar disorder in old age. Br J Psychiatry 1991; 158: 485-490.
99. Camus V, Lima C, Antonioli D, Wertheimer J. Rapid-cycling affective disorder in the elderly: clinical subtype or specific course of manic-depressive illness? J Geriatr Psychiatry Neurol 1997; 10: 105-110.
100. Conlon P. Rapid cycling mood disorder in the elderly. J Geriatr Psychiatry Neurol 1989; 2: 106-108.
101. Gnam W, Flint A. New onset rapid cycling bipolar disorder in an 87 year old woman. Can J Psychiatry 1993; 38: 324-326.
102. King D, Salem S, Meimary N. A 48 hour periodic manic-depressive illness presenting in late-life. Br J Psychiatry 1979; 135: 190-191.
103. Tohen M, Zarate C, Hennen J et al. The McLean-Harvard first-episode mania study: prediction of recovery and first recurrence. Am J Psychiatry 2003; 160: 2099-2107.
104. Tsai S, Kuo C, Chen C, Lee H. Risk factors for completed suicide in bipolar disorder. J Clin Psychiatry 2002; 63: 469-476.
105. Pinkahana J, Happell B, Keks N. Suicide and schizophrenia: a review of literature for the decade (1990-1999) and implications for mental health nursing. Issues Ment Health Nurs 2003; 24: 27-43.
106. Suppes T, Dennehy EB, Gibbons EW. The longitudinal course of bipolar disorder. J Clin Psychiatry 2000; 61(Suppl.): 23-30.
107. Kessler RC, Rubinow DR, Holmes C, Abelson J, Zhao S. The epidemiology of DSM-III-R bipolar I disorder in a general population survey. Psychol Med 1997; 27: 1079-1089.
108. Cassidy F, Ahearn P, Carroll B. Substance abuse in bipolar disorder. Bipolar Disord 2001; 3: 181-188.
109. Ponce H, Kunik M, Molinari V, Orengo C, Workman R, Reich L. Divalproex sodium treatment in elderly male bipolar patients. J Geriatr Drug Therapy 1999; 12: 55-63.
110. Sajatovic M, Popli A, Semple W. Health resource utilization over a ten-year period by geriatric veterans with schizophrenia and bipolar disorder. J Geriatr Psychiatry Neurol 1996; 15: 128-133.
111. Molinari V, Marmion J. Relationship between affective disorders and axis II diagnoses in geropsychiatric patients. J Geriatr Psychiatry Neurol 1995; 8: 61-64.
112. Himmelhoch J, Neil J, May S, Fuchs C, Licata S. Age, dementia, dyskinesias, and lithium response. Am J Psychiatry 1980; 137: 941-945.
113. Regenold WT, Thapar RK, Marano C, Gavirneni S, Kondapavaluru PV. Increased prevalence of type 2 diabetes mellitus among psychiatric inpatients with bipolar I affective and schizoaffective disorders independent of psychotropic drug use. J Affect Disord 2002; 70: 19-26.
114. Ruzickova M, Slaney C, Garnham J, Alda M. Clinical features of bipolar disorder with and without comorbid diabetes mellitus. Can J Psychiatry 2003; 48: 458-461.
115. Krauthammer C, Klerman G. Secondary mania. Arch Gen Psychiatry 1978; 35: 1333-1339.
116. Evans D, Byerly MJ, Greer RA. Secondary mania: diagnosis and treatment. J Clin Psychiatry 2001; 56(Suppl. 3): 31-37.
117. Tsai S, Lee H, Shang C, Chen C. The Correlates of Cognitive Dysfunction in Early-onset Elderly Bipolar Patients. Eleventh National Congress of the International Psychogeriatrics Association, Chicago, 2003.
118. Casey DA, Fitzgerald B. Mania and pseudodementia. J Clin Psychiatry 1988; 49: 73-74.
119. Cowdry R, Goodwin F. Dementia of bipolar illness: diagnosis and response to lithium. Am J Psychiatry 1981; 138: 1118-1119.
120. Kawai M, Miaymoto K, Miyamoto M. A case of elderly manic-depression with dementia-like symptoms in a manic phase. Clin Gerontol 1990; 9: 15-21.
121. Weintraub D, Lippmann S. Delirious mania in the elderly. Int J Geriatr Psychiatry 2001; 16: 374-377.
122. Burt T, Prudic J, Peyser S, Clark J, Sackheim H. Learning and memory in bipolar and unipolar major depression: effects of aging. Neuropsychiatr Neuropsychol Behav Neurol 2000; 13: 246-253.
123. Savard R, Rey A, Post R. Halstead-Reitan category test in bipolar and unipolar affective disorders: relationship to age and phase of illness. J Nerv Ment Dis 1980; 168: 297-304.
124. Harvey P, Powchik P, Parrella M, White L, Davidson M. Symptom severity and cognitive impairment in chronically hospitalised geriatric patients with affective disorders. Br J Psychiatry 1997; 170: 369-374.
125. Young R, Nambudiri D, Jain H, de Asis H, Alexopoulos G. Brain computed tomography in geriatric manic disorder. Biol Psychiatry 1999; 45: 1063-1065.
126. McDonald W, Krishnan R, Doraiswamy M, Blazer D. Occurrences of subcortical hyperintensities in elderly subjects with mania. Psychiatry Res Neuroimag 1991; 40: 211-220.
127. Fukikawa T, Yamawaki S, Touhouda Y. Silent cerebral infarctions in patients with late-onset mania. Stroke 1995; 26: 946-949.
128. Rabins P, Aylward E, Holyrod S, Pearlson G. MRI findings differentiate between late-onset schizophrenia and late-life mood disorder. Int J Geriatr Psychiatry 2000; 15: 954-960.
129. Bryant-Comstock L, Stender M, Devercelli G. Health care utilization and costs among privately insured patients with bipolar I disorder. Bipolar Disord 2002; 4: 398-405.
130. Brennan P, Nichols K, Moos R. Long-term use of VA mental health services by older patients with substance use disorders. Psychiatr Serv 2002; 53: 836-841.
131. Cradock-O'Leary J, Young A, Yano E, Wang M, Lee M. Use of general medical services by VA patients with psychiatric disorders. Psychiatr Serv 2002; 53: 874-878.
132. Pandi-Perumal S, Seilsb L, Kayumovc M et al. Senescence, sleep, and circadian rhythms. Aging Res Rev 2002; 1: 559-604.
133. Karel M. Aging and depression: vulnerability and stress across adulthood. Clin Psychol Rev 1997; 17: 847-879.
134. Lawton M, Kleban M, Rajagopal D. Dimensions of affective experience in three age groups. Psychol Aging 1992; 7: 171-184.
135. Monk TRC Jr, Kupfer D, Hoch C, Carrier J, Houck P. Differences over the life span in daily life-style regularity. Chronobiol Int 1997; 14: 295-306.
136. Spar J, Ford C, Liston E. Bipolar affective disorder in aged patients. J Clin Psychiatry 1979; 40: 504-507.
137. Stevick C. Some demographic and diagnostic characteristics of a geriatric population in a state geriatric facility. J Am Geriatr Soc 1980; 28: 426-429.
138. Chacko R, Molinari V, Marmion J, Adams G, Moffic S. DSM III diagnosis in the geropsychiatric patient. Clin Gerontol 1984; 2: 3-14.
139. Mei-Tal V, Meyers B. Empirical study on an inpatient psychogeriatric unit: diagnostic complexities. Int J Psychiatry Med 1985-6; 15: 91-109.
140. Molinari V. Demographic and psychiatric characteristics of 390 consecutive discharges from a geropsychiatric ward. Clin Gerontol 1990; 10: 35-45.
141. Webster J, Grossberg G. Late-life psychotic symptoms. Am J Geriatr Psychiatry 1998; 6: 196-202.
142. Yang C, Hwang J, Tsai S, Liu C. The clinical applications of mini-mental state examination in geropsychiatric inpatients. Int J Psychiatry Med 2000; 30: 277-285.
143. Endicott J, Spitzer R. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry 1978; 33: 766-771.
144. Noaghiul S, Narayan M, Nelson J. Divalproex treatment of mania in elderly patients. Am J Geriatr Psychiatry 1998; 6: 257-262.
145. Chen D, Altshuler L, Melnyk K, Erhart S, Miller E, Mintz J. Efficacy of lithium vs. valproate in the treatment of mania in the elderly: a retrospective study. J Clin Psychiatry 1999; 60: 181-1886.
146. Young R, Jain H, Kiosses D, Meyers B. Antidepressant-associated mania in late life. Int J Geriatr Psychiatry 2003; 18: 421-424.
147. James N. Early- and late-onset bipolar affective disorder: a genetic study. Arch Gen Psychiatry 1977; 34: 715-717.
148. Baron M, Mendlewicz J, Klotz J. Age-of-onset and genetic transmission in affective disorders. Acta Psychiatr Scand 1981; 64: 373-380.
149. Tohen M, Shulman K, Satlin A. First-episode mania in late-life. Am J Psychiatry 1994; 151: 130-132.
150. Hays J, Krishnan K, George L, Blazer D. Age at first onset of bipolar disorder: demographic, family history, and psychosocial correlates. Depress Anxiety 1998; 7: 76-82.