UNIPOLAR MANIA RECONSIDERED - EVIDENCE FROM AN ELDERLY COHORT

Earlier studies have failed to differentiate the unipolar manic subtyp e from bipolar patients with both manic and depressive episodes. This retrospective cohort study of 50 elderly manic in-patients identified six patients (12%) who met strict criteria for a course of unipolar ma nia. Significant differences emerged in age at onset. with a mean of 4 1.2 years for unipolar mania compared with 64.7 years for the others. Consequently, clinical course was significantly longer, 27.7 v. 7.4 ye ars. Elderly patients pursuing a unipolar manic course are among the v ery few elderly 'bipolars' whose illness begins early in life. Recent neuroradiological investigations and data from geriatric studies sugge st that the concept of unipolar mania is worthy of further investigati on.