As detailed on the slide, age and polarity at onset are important clinical indicators in bipolar disorder.1-3 An earlier age at onset has been linked to many poor outcomes, and polarity at onset appears to predict the later predominant disease polarity as well as some severe outcomes.1-3 Depressive polarity of onset is approximately twice as common as manic polarity of onset, and predicts a more cyclic and chronic disease course.2
References:
1. Etain B, Lajnef M, Bellivier F, et al. Clinical expression of bipolar disorder type I as a function of age and polarity at onset: convergent findings in samples from France and the United States. J Clin Psychiatry 2012; 73 (4): e561–656.
2. Daban C, Colom F, Sanchez-Moreno J, et al. Clinical correlates of first-episode polarity in bipolar disorder. Compr Psychiatry 2006; 47 (6): 433–437.
3. Kalman JL, Olde Loohuis LM, Vreeker A, et al. Characterisation of age and polarity at onset in bipolar disorder. Br J Psychiatry 2021; 219 (6) 659–669.