Antidepressant use in older age bipolar disorder (OABD): Results from the GAGE-BD international consortium
Bibliographic record
Abstract
BACKGROUND: Antidepressants are still commonly prescribed in bipolar disorders, despite ongoing controversy of the potential risk of inducing hypomania/mania. There is limited knowledge about the characteristics of antidepressant use in older age bipolar disorder (OABD; age ≥50) in the current literature. AIM: To describe antidepressant use, sociodemographic and clinical correlates of a global sample of OABD individuals. METHODS: The Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) consortium provided cross-sectional international data on OABD individuals (n = 746) and younger-age bipolar disorder (YABD, age <50 years; n = 692) regarding antidepressant use. Multivariate logistic regression was employed to assess the association between AD use with demographic and clinical variables. RESULTS: Of 1252 participants, 33.1 % of OABD individuals and 38.1 % of YABD individuals were using antidepressants. In multivariable models among OABD, antidepressant use was associated with BD type II (OR = 1.61, 95 % CI: 1.09-2.38), higher depression severity (mild-to-moderate: OR = 1.86, 95 % CI: 1.13-3.06; severe: OR = 4.23, 95 % CI: 2.38-7.50), lower YMRS scores (OR = 0.93, 95 % CI: 0.89-0.97), female sex (OR = 1.37, 95 % CI: 1.00-1.89), lower education (OR = 0.61, 95 % CI: 0.43-0.86), and being unemployed (OR = 0.69, 95 % CI: 0.50-0.96). Antidepressant monotherapy was reported in 18 % of OABD users (n = 46) and 19 % of YABD users (n = 51). These findings suggest that both clinical severity and sociodemographic characteristics influence antidepressant prescribing in OABD. CONCLUSION: Antidepressant use was less prevalent in OABD compared to YABD, and associated with female sex, lower education, lack of occupation, type II BD, higher depression severity and lower mania scores. In OABD, antidepressants appear to be used more commonly in contexts where they may be clinically more indicated, such as increased depression severity.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".