@article{ref1,
title="Factors associated with onset-age in major affective disorders",
journal="Acta psychiatrica Scandinavica",
year="2022",
author="Miola, Alessandro and Tondo, Leonardo and Salvatore, Paola and Baldessarini, Ross J.",
volume="146",
number="5",
pages="456-467",
abstract="BACKGROUND: Research findings on factors associated with onset-age (OA) with bipolar (BD) and major depressive disorders (MDD) have been inconsistent, but often indicate greater morbidity following early OA. <br><br>METHODS: We considered factors associated with OA in 1033 carefully evaluated, systematically followed mood disorder subjects with DSM-5 BD (n = 505) or MDD (n = 528), comparing rates of descriptive and clinical characteristics following early (age <18), intermediate (18-40), or later onset (≥40 years), as well as regressing selected measures versus OA. Exposure time (years ill) was matched among these subgroups. <br><br>RESULTS: As hypothesized, many features were associated with early OA: familial psychiatric illness, including BD, greater maternal age, early sexual abuse, nondepressive first episodes, co-occurring ADHD, suicide attempts and violent suicidal behavior, abuse of alcohol or drugs, smoking, and unemployment. Other features increased consistently with later OA: %-time-depressed (in BD and MDD, women and men), as well as depressions/year and intake ratings of depression, educational levels, co-occurring medical disorders, rates of marriage and number of children. <br><br>CONCLUSIONS: OA averaged 7.5 years earlier in BD versus MDD (30.7 vs. 38.2). Some OA-associated measures may reflect maturation. Associations with family history and suicidal risk with earlier OA were expected; increases of time-depressed in both BD and MDD with later OA were not. We conclude that associations of OA with later morbidity are complex and not unidirectional but may be clinically useful.<p /><p>Language: en</p>",
language="en",
issn="0001-690X",
doi="10.1111/acps.13497",
url="http://dx.doi.org/10.1111/acps.13497"
}