The impact of age at onset of bipolar I disorder on functioning and clinical presentation

Objectives: Recent studies have proposed the existence of three distinct subgroups of bipolar 1 disorder based on age at onset (AAO). The present study aims to investigate potential clinical and functional differences between these subgroups in an Australian sample.

Methods: Participants (n = 239) were enrolled in the Bipolar Comprehensive Outcomes Study (BCOS), a 2-year longitudinal, observational, cross-sectional study. Assessment measures included the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD21), Clinical Global Impressions Scale (CGI-BP), SF-36, SLICE/Life Scale, and the EuroQol (EQ-5D). Participants were also asked about their age at the first major affective episode.

Results: Three AAO groups were compared: early (AAO < 20, mean = 15.5 ± 2.72; 44.4% of the participants); intermediate (AAO 20–39, mean = 26.1 ± 4.8; 48.14% of the participants) and late (AAO > 40, mean = 50.6 ± 9.04; 7.4% of the participants). Higher rates of depression, suicidal ideation and binge drinking were reported by the early AAO group. This group also reported poorer quality of life in a number of areas. The early AAO group had a predominant depressive initial polarity and the intermediate group had a manic predominance.

Conclusion: Early AAO is associated with an adverse outcome.

William Wardell's 1859 St John's College - a rare realisation of Pugin's ideal Catholic College?

William Wardell’s St John’s College, Sydney, considered the grandest and architecturally most distinguished university college in New South Wales, is an exceptional example of 19th century Gothic Revival architecture.  The information board outside the college states that St John’s is ‘a rare realisation of Pugin’s ideal Catholic College’ and further that ‘it demonstrates [Pugin]’s profound influence on the work of Wardell’. This is but a small part of the story. The commission for St John’s College was far more complex.  The correspondence between the architects, William Wardell, Edmund Blacket and others, and St John’s Council indicates that right from the beginning there was a general lack of understanding of Wardell’s original design concept for the building. This has continued to the present day, as evidenced by the information on the board outside St John’s College, in which it is incorrectly assumed that Wardell’s proposal included a quadrangle as featured in Pugin’s ‘ideal College’. This paper, based largely on primary sources, investigates such claims about St John’s, considers William Wardell and the Gothic Revival, examines St John’s College within the University of Sydney – its design and its translation and posits a few conclusions leading to new understandings.