Factors associated with onset-age in major affective disorders: What to look for?

Acta Psychiatrica ScandinavicaScott Cunningham MD PhD, et al. | September 08, 2022



An understanding of the risk factors, especially the non-shared risk factors for BD and MDD may facilitate the accurate diagnosis of BD, especially in patients without a hypomanic or manic episode. Accordingly, the appropriate treatment can be initiated.

The clinical characteristics of patients with BD (n=505) and MDD (n=528) were reviewed. Onset-age for BD and MDD was categorized as follows: early, < 18 years of age; intermediate, 18-40 years of age; and late, > 40 years of age.

On average, patients with BD had a 7.5-year earlier age of onset than patients with MDD.

Factors associated with early-onset affective disorders included the following: a family history of psychiatric illness; increased maternal age; early sexual abuse; a non-depressive first episode; co-existing attention deficit/hyperactivity disorder; suicide attempts; violent suicidal behavior; abuse of alcohol and drugs; smoking; and unemployment.

Factors associated with late-onset affective disorders included the following: percentage of time depressed; number of depression episodes/y; education level; co-morbidities; marriage; and number of children.