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Late onset mania

F Smeets, J W Ummels, F R J Verhey, S P J van Alphen
An 87-year-old man showed behavioral disinhibition and nocturnal restlessness as well as short-term memory problems. We diagnosed late-onset frontotemporal dementia (LO-FTD), a relatively rare disease. Based on the course of the disease progress, we ruled out medication-induced mania and bipolar disorder. Given the results of the CT-scan, we also dismissed the possibility that the patient was suffering from dementia based on Alzheimer's disease and vascular factors that followed an atypical course. Our article illustrates the complexity of the diagnostic process investigating LO-FTD...
2016: Tijdschrift Voor Psychiatrie
Beatrice Roiter, Giorgio Pigato, Giulio Perugi
Age of onset can have a significant impact on clinical course and pathophysiological mechanism of bipolar disorder. Late-onset bipolar episodes are more likely linked to medical illnesses and so are frequently classified as "secondary" forms of mood disorder. We discuss the case of a patient who at the age of 58 presented his first delusional-manic episode. He also had mild frontal and occipital cortical atrophy, white matter posterior ischemic lesions, and small basal ganglia calcifications. Seven years later, he presented a second manic episode with new emergent hyperkinetic choreiform symptoms...
2016: Case Reports in Psychiatry
Yen-Chun Kuo, Yen-Chung Lin, Pao-Huan Chen
No abstract text is available yet for this article.
August 2016: Journal of Clinical Psychopharmacology
Chung-Hao Yang, Yu-Chen Lin, Po-Han Chou, Hung-Chieh Chen, Chin-Hong Chan
Recurrent manic-like episodes can be induced by hyponatremia possibly due to empty sella syndrome. In the present case, the patient was proven to have syndrome of inappropriate antidiuretic hormone (SIADH) secretion with manic symptoms that resolved after the normalization of the plasma sodium level.To our knowledge, this is the first case of hyponatremia-induced manic symptoms in a patient with empty sella syndrome. More attention should be paid to late-onset mania, because it may be the sign of a more serious medical problem...
February 2016: Medicine (Baltimore)
Musa Sami, Hina Khan, Ramin Nilforooshan
AIMS: Although First Episode Mania presenting over the age of 50 is reported in several cases, there has been little systematic compilation of these case reports. We report a review of case reports on these subjects. METHODS: We undertook a literature search on MEDLINE, PsychInfo and EMBASE to identify case reports of first episode of mania or hypomania presenting over the age of 50. RESULTS: 35 cases were identified. 29/35 (82%) had a suspected underlying organic cause...
December 1, 2015: Journal of Affective Disorders
Rahul Saha, Kiran Jakhar
Oligodendrogliomas may present with a variety of psychological symptoms but it only rarely presents with mania. The patient described in this case report is a 55-year-old man with a three year history of progressive mania who was initially diagnosed as chronic mania but a subsequent MRI identified a brain tumor. This report highlights the importance of considering differential organic diagnosis when patients present with atypical presentations of psychiatric disorders. A brain tumor should be considered and brain imaging studies conducted for patients with a late age of onset who do not respond to appropriate medication...
June 25, 2015: Shanghai Archives of Psychiatry
Piyush Das, Amit Chopra, Abhishek Rai, Preetha Sharone Kuppuswamy
OBJECTIVE: The aim of the present case report was to describe the late onset of recurrent mania in a patient after ischemic injury to the cerebellum and dorsolateral medulla. METHODS: We studied an 86-year-old male with no prior psychiatric history who developed recurrent episodes of mania following a brain stroke. Additionally, he had neurological symptom constellation typical of Wallenberg syndrome. RESULTS: Magnetic resonance imaging of the brain revealed infarction in the inferomedial right cerebellar hemisphere and the right dorsolateral medulla in the right posterior inferior cerebellar artery (PICA) distribution...
September 2015: Bipolar Disorders
Frances Biffin, Steven Tahtalian, Kate Filia, Paul B Fitzgerald, Anthony R de Castella, Sacha Filia, Michael Berk, Seetal Dodd, Pam Callaly, Lesley Berk, Katarina Kelin, Meg Smith, William Montgomery, Jayashri Kulkarni
OBJECTIVES: Recent studies have proposed the existence of three distinct subgroups of bipolar 1 disorder based on age at onset (AAO). The present study aims to investigate potential clinical and functional differences between these subgroups in an Australian sample. METHODS: Participants (n = 239) were enrolled in the Bipolar Comprehensive Outcomes Study (BCOS), a 2-year longitudinal, observational, cross-sectional study. Assessment measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD21), Clinical Global Impressions Scale (CGI-BP), SF-36, SLICE/Life Scale, and the EuroQol (EQ-5D)...
August 2009: Acta Neuropsychiatrica
Soyeon Park, Boram Park, Min Kyung Koh, Yeon Ho Joo
BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebrovascular disease, clinically characterized by variable manifestations of migraine, recurrent transient ischemic attack or lacunar strokes, cognitive decline, and mood disturbances. However, manic episodes have rarely been documented as an initial symptom of CADASIL and bipolar disorder presenting as the first manifestation in CADASIL has not been reported previously from evaluations by psychiatrists or psychological testing by psychologists...
2014: BMC Psychiatry
Frits Oostervink, Willem A Nolen, Rob M Kok
BACKGROUND: Information about differences between younger and older patients with bipolar disorder and between older patients with early and late age of onset of illness during long-term treatment is scarce. OBJECTIVES: This study aimed to investigate the differences in treatment and treatment outcome between older and younger manic bipolar patients and between early-onset bipolar (EOB) and late-onset bipolar (LOB) older patients. METHOD: The European Mania in Bipolar Longitudinal Evaluation of Medication study was a 2-year prospective, observational study in 3459 bipolar patients on the treatment and outcome of patients with an acute manic or mixed episode...
February 2015: International Journal of Geriatric Psychiatry
P A Geoffroy, M Leboyer, J Scott
INTRODUCTION: Bipolar disorder (BD) is a life course illness; and there is increasing awareness of the many personal, social and economic consequences of the illness in older adults. However, it is important to emphasize that BD usually begins in late adolescence or early adulthood and 75 % cases have a first episode in this age period. This early onset and the associated level of disability mean that BD is the 4th leading cause of global disease burden in adolescents and young adults...
February 2015: L'Encéphale
Luchezar G Hranov, Petra Marinova, Maria Stoyanova, Milena Pandova, Georgi Hranov
INTRODUCTION: There are a lot of unresolved issues associated with the classification, diagnosis, clinical management and understanding of the underlying pathogenic mechanisms of bipolar affective disorder. AIM: To search for discrete endophenotypes in BAD. SUBJECTS AND METHODS: We studied various bipolar I and II and recurrent depression patient samples and healthy controls using descriptive data, self and clinician-rated scales for neurological and psychopathological symptoms, neurocognitive instruments, and inventories for temperamental and characterological features...
September 2013: Psychiatria Danubina
Elena Antelmi, Margherita Fabbri, Lucia Cretella, Maria Guarino, Andrea Stracciari
OBJECTIVE: To describe a patient with a new onset bipolar disorder (BD) type II, secondary to a lacunar state. BACKGROUND: Post-stroke BD is rare and mainly associated with lesions involving the prefrontal-striatal-thalamic circuit. MATERIALS AND METHODS: A 51-year-old woman came to our attention for a mood disorder of recent onset. Personal and family history was negative for psychiatric disorders. At 49, she had suffered acute left-sided limb weakness that improved spontaneously four days later...
August 20, 2013: Behavioural Neurology
Annemiek Dols, Ralph W Kupka, Anouk van Lammeren, Aartjan T Beekman, Martha Sajatovic, Max L Stek
OBJECTIVES: Since there is a worldwide steady increase in the number of individuals living longer and an expected increase in the number of older adults who will be diagnosed with bipolar disorder, there is a growing need to better understand late-life mania. We provide in this review a report of published studies focusing on the prevalence of late-life mania in the community and in senior psychiatric care facilities. METHODS: We conducted a search of PubMed and Psychinfo databases using combinations of the keywords bipolar, manic/a, manic depression, elderly, and older including English-language reports presenting quantitative data on the prevalence of mania in adults over the age of 50 years...
March 2014: Bipolar Disorders
Jean-Michel Azorin, Frank Bellivier, Arthur Kaladjian, Marc Adida, Raoul Belzeaux, Eric Fakra, Elie Hantouche, Sylvie Lancrenon, Jean-Louis Golmard
BACKGROUND: Many studies have used admixture analysis to separate age-at-onset (AAO) subgroups in bipolar patients, but few have looked at the phenomenological characteristics of these subgroups, in order to find out phenotypic markers. METHODS: Admixture analysis was applied to identify the model best fitting the observed AAO distribution of a sample of 1082 consecutive DSM-IV bipolar I manic inpatients who were assessed for demographic, clinical, course of illness, comorbidity, and temperamental characteristics...
September 25, 2013: Journal of Affective Disorders
Pierre Alexis Geoffroy, Bruno Etain, Jan Scott, Chantal Henry, Stéphane Jamain, Marion Leboyer, Frank Bellivier
Bipolar disorder is a multifactorial psychiatric disorder with developmental and progressive neurophysiological alterations. This disorder is typically characterized by cyclical and recurrent episodes of mania and depression but is heterogeneous in its clinical presentation and outcome. Although the DSM-IV-TR criteria identify several features that are of phenomenological relevance, these are of less utility for defining homogeneous subgroups, for analyses of correlations with biomarkers or for directing focused medication strategies...
September 2013: Journal of Physiology, Paris
Çetin Turan, Sermin Kesebir, Handan Meteris, Mustafa Ülker
Neurologic disorders can produce "secondary" mania, and clinicians must distinguish secondary mania from bipolar disorders (BD). Patients with new and late onset mania require an evaluation that includes a thorough history, a neurologic examination, neuroimaging, and other selected tests. Neurologic causes of mania include strokes in the right basotemporal or inferofrontal region, strokes or tumors in the perihypothalamic region, Huntington's disease and other movement disorders, multiple sclerosis and other white matter diseases, head trauma, infections such as neurosyphilis and Creutzfeldt-Jakob disease, and frontotemporal lobar degeneration...
2013: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
Jules Angst, Michael P Hengartner, Alex Gamma, Detlev von Zerssen, Felix Angst
The purpose is to analyse differences in mortality among patients with major depressive disorders (MDD), bipolar-II (BP-II), bipolar-I (BP-I) disorders and mania with or without minor depressive disorders and to identify risk factors of mortality. The sample represents all admissions for depression or mania over 5 years (1959-1963) to the Psychiatric Hospital of Zurich University, serving a large area. 403 patients were included and followed up every 5 years until 1985; thereafter, mortality data were collected repeatedly until 2009 when 352 (87 %) patients had died...
August 2013: European Archives of Psychiatry and Clinical Neuroscience
Judith Proudfoot, Alexis Whitton, Gordon Parker, Justin Doran, Vijaya Manicavasagar, Kristy Delmas
BACKGROUND: Early intervention significantly decreases the impact of bipolar disorder. However, there is little research investigating triggers that may be unique precipitants of manic/hypomanic episodes, and how these may differ from triggers specific to bipolar depression, in young adults with the disorder. METHODS: Individuals aged 18 to 30 years who had been diagnosed with bipolar disorder (n=198) completed an online survey to identify triggers unique to mania/hypomania and depression, as well as triggers which were common to both...
December 20, 2012: Journal of Affective Disorders
Amy L Price, Gabrielle R Marzani-Nissen
Bipolar disorders are common, disabling, recurrent mental health conditions of variable severity. Onset is often in late childhood or early adolescence. Patients with bipolar disorders have higher rates of other mental health disorders and general medical conditions. Early recognition and treatment of bipolar disorders improve outcomes. Treatment of mood episodes depends on the presenting phase of illness: mania, hypomania, mixed state, depression, or maintenance. Psychotherapy and mood stabilizers, such as lithium, anticonvulsants, and antipsychotics, are first-line treatments that should be continued indefinitely because of the risk of relapse...
March 1, 2012: American Family Physician
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