Hospitalisation for Bipolar Disorder: Comparison between Young and Elderly Patients

Isabelle Rouch^1,2*, Claude Marescaux³, Catherine Padovan^4,5, Thierry D’Amato^4,6, Benoit Saitta³, Bernard Laurent¹, Romain Rey⁴, Alexis Lepetit^2,4, Jean Michel Dorey⁴

¹Neurology Unit, University Hospital of Saint-Etienne, Saint Etienne, France.
²Geriatrics Unit, Charpennes Hospital, University Hospital of Lyon, Villeurbanne, France.
³Département d’Information Médicale, Vinatier Hospital, Bron, France.
⁴Memory Center-Gerontopsychiatry Unit, Vinatier Hospital, Bron, France.
⁵Brain Dynamics and Cognition Team, Lyon Neurosciences Research Center,.
⁶Université Lyon 1, Lyon, France.

DOI: 10.4236/psych.2015.61011                

Abstract

Although Bipolar Disorder (BD) often affects young subjects, the number of elderly patients suffering from BD is rising as life expectancy increases. Few studies addressed the hospitalisation characteristics according to patient age. The goal of this preliminary study was to compare the hospitalisation characteristics of young and elderly patients suffering from BD admitted in a psychiatric hospital. The data were selected from the French nation-wide hospital database for psychiatry. The study included patients hospitalised in a French psychiatric hospital from January 2002 to December 2012. The hospitalisation characteristics were compared between young (YBD) and elderly bipolar patients (EBD). A total of 1842 patients were hospitalised during the 11-year period. Among them, 707 (38.4%) were 60 years old and over. The mean length of stay was significantly longer for the EBD group than for the YBD group (48.1 vs 30.4 days, p < 0.0001). Among the patients first hospitalised in 2002, the readmission rate was significantly higher for the EBD (67.9%) than for the YBD (55.2%) group (p = 0.026). In contrast, the rate of compulsory hospitalisations was higher among the YBD than among the EBD group. Our findings confirm that BD in old age remains a severe disease requiring longer hospitalisations than for BD in younger patients. Future prospective studies are needed to better understand the origin of these differences.

Keywords

Bipolar Disorder, Elderly, Hospitalisation

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Bauer, M., Unutzer, J., Pincus, H. A., & Lawson, W. B. (2002). Bipolar Disorder. Mental Health Services Research, 4, 225-229. http://dx.doi.org/10.1023/A:1020968616616
[2]	Blackburn, I. M., Ashworth, C. M., & Loudon, J. B. (1977). A New Scale for Measuring Mania. Psychological Medicine, 7, 453-458. http://dx.doi.org/10.1017/S0033291700004438
[3]	Cassano, G. B., McElroy, S. L., Brady, K., Nolen, W. A., & Placidi, G. F. (2000). Current Issues in the Identification and Management of Bipolar Spectrum Disorders in “Special Populations”. Journal of Affective Disorders, 59, S69-S79. http://dx.doi.org/10.1016/S0165-0327(00)00180-4
[4]	Depp, C. A., Jin, H., Mohamed, S., Kaskow, J., Moore, D. J., & Jeste, D. V. (2004). Bipolar Disorder in Middle-Aged and Elderly Adults: Is Age of Onset Important? The Journal of Nervous and Mental Disease, 192, 796-799. http://dx.doi.org/10.1097/01.nmd.0000145055.45944.d6
[5]	Gildengers, A. G., Butters, M. A., Seligman, K., McShea, M., Miller, M. D., Mulsant, B. H., et al. (2004). Cognitive Functioning in Late-Life Bipolar Disorder. The American Journal of Psychiatry, 161, 736-738. http://dx.doi.org/10.1176/appi.ajp.161.4.736
[6]	Gonzalez-Pinto, A. M., Dardennes, R., de Zélicourt, M., Lopez, P., Oliveros, R.G., Vieta, E., Barbeito, S., Echevarria, E., & Fagnani, F. (2010). In-Patient Care Costs of Patients with Bipolar I Disorder: A Comparison between Two European Centers. Journal of Affective Disorders, 121, 152-155. http://dx.doi.org/10.1016/j.jad.2009.05.010
[7]	Hirschfeld, R. M. A., Calabrese, J. R., Weissman, M. M., Reed, M., Davies, M. A., Frye, M. A., et al. (2003). Screening for Bipolar Disorder in the Community. Journal of Clinical Psychiatry, 64, 53-59. http://dx.doi.org/10.4088/JCP.v64n0111
[8]	Kessing, L. V. (2006). Diagnostic Subtypes of Bipolar Disorder in Older versus Younger Adults. Bipolar Disorder, 8, 56-64. http://dx.doi.org/10.1111/j.1399-5618.2006.00278.x
[9]	Oostervink, F., Boomsma, M. M., Nolen, W. A., The EMBLEM Advisory Board (2009). Bipolar Disorder in the Elderly; Different Effects of Age and of Age of Onset. Journal of Affective Disorders, 116, 176-183. http://dx.doi.org/10.1016/j.jad.2008.11.012
[10]	Osby, U., Tiainen, A., Backlund, L., Edman, G., Adler, M., Hallgren, J., SennfAlt, K., van Baardewijk, M., & Sparen, P. (2009). Psychiatric Admissions and Hospitalization Costs in Bipolar Disorder in Sweden. Journal of Affective Disorders, 115, 315-322. http://dx.doi.org/10.1016/j.jad.2008.09.011
[11]	Pini, S., de Queiroz, V., Pagnin, D., Pezawas, L., Angst, J., Cassano, G. B., & Wittchen, H.-U. (2005). Prevalence and Burden of Bipolar Disorders in European Countries. European Neuropsychopharmacology, 15, 425-434. http://dx.doi.org/10.1016/j.euroneuro.2005.04.011
[12]	Sajatovic, M., Bingham, C. R., Campbell, E. A., & Fletcher, D. F. (2005). Bipolar Disorder in Older Adult Inpatients. The Journal of Nervous and Mental Disease, 193, 417-419. http://dx.doi.org/10.1097/01.nmd.0000165296.50985.a8
[13]	Sajatovic, M., Bingham, C. R., Campbell, E. A., & Fletcher, D. F. (2006). Factors Associated with Functional Decline of Hospitalised Older Persons Following Discharge from an Acute Geriatric Unit. Annals Academy of Medicine Singapore, 35, 17-23.
[14]	Wu, H.Y., Sahadevan, S., & Ding, Y.Y. (2004). Age-Related Modifiers of Clinical Presentation and Health Service Use among Veterans with Bipolar Disorder. Psychiatric Services, 55, 1014-1021. http://dx.doi.org/10.1176/appi.ps.55.9.1014