Evaluation and treatment of older-age bipolar disorder: a narrative review

Drugs in Context

article

Pallavi Joshi¹  Gargi Bhattacharya²  Rajesh R Tampi²  Sheila Gupta³ 

[1] Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II;Dermatology Department, Grande Ospedale Metropolitano, Reggio Calabria;Dermatology Department, DissaL, Policlinico San Martino IRCCS

关键词: antipsychotics;    bipolar disorder;    early-onset bipolar disorder;    electroconvulsive therapy;    lithium;    mood stabilizers;    older-age bipolar disorder;    psychosocial treatments;   

DOI  :  10.7573/dic.2021-1-8

学科分类：社会科学、人文和艺术（综合）

来源: C S F Medical Communications Ltd.

【 摘 要 】

Objectives: This narrative review aims to synthesize information from the literature regarding older-age bipolar disorder (OABD) in order to provide up-to-date information on this important illness. Methods: We searched Ovid (Medline, Embase and PsychInfo) on October 1, 2020, using the keywords “bipolar disorder”, “older adults” and “elderly” to identify relevant articles on OABD. Additionally, the bibliography of identified articles was reviewed for pertinent studies. Discussions: OABD is a term that is used to describe bipolar disorder (BD) occurring amongst individuals ≥50 years of age. Evidence indicates that OABD accounts for a quarter of all cases of BD. When compared to individuals with early-onset BD, individuals with OABD have a greater association with cerebrovascular disease and other neurological disorders, less family history of mood disorders, and utilize almost four times the total amount of mental health services. In addition, they are four times more likely to have psychiatric hospitalizations when compared to age-matched controls. Despite a dearth of controlled studies on the use of pharmacotherapy amongst individuals with OABD, available evidence from mixed-age studies indicates the efficacy of commonly used medications in individuals with early-onset BD. Additionally, psychosocial treatments have been found to be effective as adjunctive management strategies amongst individuals with OABD. Furthermore, electroconvulsive therapy may be effective in the treatment of refractory cases of OABD. Conclusions: There is a great need for an improved understanding of the phenomenology and neurobiology of OABD. Additionally, research into effective treatments for this serious psychiatric disorder will mitigate the suffering of individuals with OABD.

【 授权许可】

CC BY-NC-ND