Abstract
Objective: Our aim is to compare demographic and clinical characteristics of patients with early and late-onset diagnosed as bipolar disorder type I (BPD-I) manic episode retrospectively.
Method: A total of 24 elderly (?65 years old) hospitalized patients with bipolar disorder were divided into 2 groups as those with early-onset and late-onset disorder, according to a threshold of 50 years of age, and were retrospectively compared with 29 young patients (19-55 years old) in terms of sociodemographic characteristics, clinical symptoms, family history, prophylactic treatment, co-existing medical conditions, duration of hospitalization, psychiatric treatment, and clinical improvement.
Results: A positive family history was also more prevalent in young patients and patients with early-onset disease. Co-existing medical conditions were more common in patients with late-onset disease. A positive correlation was found between the duration of education and duration of illness. Flight of ideas and pressured speech were more commonly observed in young patients and patients with early-onset disease. While delusions of erotomanic type were more frequent in young patients, persecution delusions were more common in elderly patients. In terms of treatment, valproate was preferred in the elderly patients and antipsychotic medications were more frequently used in late-onset elderly patients when compared to early-onset elderly patients. The duration of hospitalization was longer in elderly patients than younger ones.
Conclusion: Our findings show that late-onset mania has different characteristics compared to early-onset mania in terms of clinical characteristics, symptom profile, family history, co-existing medical diseases, duration of hospitalization, and response to treatment. However, it is hard to conclude that it as a different clinical subgroup when previous studies about late-onset mania are taken into consideration. Further studies with adequate sample sizes are needed.

Key words: late-onset, early-onset, mania, elderly, bipolar disorder