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Page Background European Psychiatry 33S (2016) S56–S71

Available online at

ScienceDirect

www.sciencedirect.com

24th European Congress of Psychiatry

Workshop

Age of onset of mental disorders:

Etiopathogenetic and treatment implications

W01

Age of onset of bipolar disorders:

A systematic review and meta-analysis

G. de Girolamo

1 ,

, M. Bani

1

, J. Dagani

1

, C. Ferrari

2

, A. Pastore

3

,

G. Signorini

1

1

Saint John of God Clinical Research Center, Psychiatric Epidemiology

and Evaluation Unit, Brescia, Italy

2

Saint John of God Clinical Research Center, Statistics services,

Brescia, Italy

3

University “Aldo Moro”, Department of Basic Medical

Sciences-Neuroscience and Sense Organs- Childhood and Adolescence

Neuropsychiatry Unit, Bari, Italy

Corresponding author.

Introduction

Although the onset of bipolar disorder (BD) is usu-

ally estimated in early adulthood (Burke et al., 1990; Kessler et al.,

1997), it is still not clear which age-specific triggering factors may

contribute to the underlying vulnerability.

Objectives/aims

The presentmeta-analysis attempts to clarify the

number of untreated years of BD, from first symptoms appear-

ance, to first actions carried out by health services (first diagnosis,

treatment and hospitalization).

Methods

A literature search of three databases PubMed, Web

of Science and Psychology and Behavioral Sciences Collection

was performed, looking for peer-reviewed publications in English,

French, German and Italian language that reported the AOO of BD;

the search string adopted was “bipolar and onset”. Standardized

mean differences were calculated between (i) mean AOO, opera-

tionally defined as onset of first symptoms/episodes, and (ii) mean

AOO, operationally defined according to four criteria: first contact

with services, date of the diagnosis, first pharmacological treat-

ment, or first hospitalization.

Results

The searches yielded 8710 articles; 2424 of these arti-

cles met the inclusion criteria. A final set of 19 studies presenting

multiple definitions of AOO has been analyzed, revealing an overall

effect size of 6.96 of untreated years (Cohen’s d = 0.65)

Conclusion

To our knowledge, this is the first meta-analysis that

addresses the definition and the modulation of the AOO in bipo-

lar disorder. Identifying the time-frame of untreated illness is very

important for the best planning of timely interventions.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.935

W02

The age of onset of anxiety disorders

in samples from the general

population: A meta-analysis

J. de Lijster

, B. Dierckx , E. Utens , F. Verhulst , C. Zieldorff ,

G. Dieleman , J. Legerstee

Erasmus MC Sophia Children’s Hospital, department of Child and

Adolescent Psychiatry/psychology, Rotterdam, Netherlands

Corresponding author.

Workshop

Age of onset of mental disorders: etiopathogenetic

and treatment implications.

Background

Age of onset (AOO) of anxiety disorders could serve

as a vital statistic in the formulation of mental health policy. Previ-

ous reviews have reported on the AOO of anxiety disorders in the

general population. However, these review studies did not system-

atically estimate the AOO of different anxiety disorder subtypes,

and did not examine factors that might have influenced reported

AOO.

Objective

The aims of the present study were (1) to estimate

the AOO for all anxiety disorders and for specific subtypes, (2) to

examine gender differences in AOO of anxiety disorders, and (3) to

examine the influence of study characteristics on reported AOO.

Method

Seven electronic databases were searched with key-

words representing anxiety disorder subtypes, AOO and study

design. The inclusion criteria were studies using a general popu-

lation sample that provided data on AOO for all anxiety disorders,

or specific anxiety disorders, according to DSM-III-R, DSM-IV or

ICD-10 criteria. Meta-analysis was used to estimate AOO and gen-

der differences, while meta-regression was used to examine the

influence of study characteristics.

Results

A total of 1028 titles were examined, which yielded 24

studiesmeeting the inclusion criteria. Meta-analysis found an aver-

age AOO of all anxiety disorders of 21.3 years (95% CI: 17.46 to

25.07). Separation anxiety disorder, specific phobia and social pho-

bia had their mean onset before the age of 15 years, whereas AOO of

agoraphobia, obsessive compulsive disorder, post-traumatic stress

disorder, panic disorder and generalized anxiety disorder began

on average between 21.1 and 34.9 years. Anxiety disorder is more

common in women, but meta-analysis revealed no difference in

AOO between genders. Prospective study design and higher devel-

opmental level of the study country were associated with earlier

AOO.

Conclusion

Results from this meta-analysis indicate that anxi-

ety disorder subtypes differ in mean AOO, with onsets ranging

from early adolescence to young adulthood. These findings suggest

that prevention strategies of anxiety disorders should be directed

towards the factors associated with the development of subtypes

0924-9338/$ – see front matter