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Mental Health Service Use by Elderly Patients With Bipolar Disorder and Unipolar Major Depression

Received February 17, 1999; accepted April 16, 1999. From the NH–Dartmouth Psychiatric Research Center, Lebanon, NH. Address correspondence to Dr. Bartels, NH–Dartmouth Psychiatric Research Center, 2 Whipple Place, Suite 202, Lebanon, NH 03766.

Symptoms, functioning, and mental health service use were compared in older outpatients with bipolar disorder and unipolar depression. Bipolar outpatients (n=37, mean age=69.7) had higher total symptom severity and positive symptom scores, more impaired community-living skills, and earlier age at onset of illness than patients with unipolar depression (n=85, mean age=70.9). Bipolar elderly patients used almost four times the total amount of mental health services and were four times more likely to have had a psychiatric hospitalization over the previous 6 months. These findings underscore the need for effective services for elderly patients with bipolar disorder, who account for a minority of patients with affective disorders, but use a disproportionate amount of costly services.

Key Words: Bipolar Disorder • Depression • Health Services