{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:44:59Z","timestamp":1787071499217,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Late-onset bipolar disorder (LOB) presents unique diagnostic and management challenges as various symptom overlaps with neurocognitive disorders, medical comorbidities, and age-related physiological changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases:<\/jats:title>\n                    <jats:p>We report four elderly patients presenting with first-episode mania, highlighting clinical trajectories, comorbidities, and treatment responses. Three patients had metabolic comorbidities, while two had family history of psychiatric illness. Neuroimaging revealed small vessel ischemic changes in two cases, suggesting a vascular contribution. All patients required inpatient care and responded well to mood stabilizers and antipsychotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Further research is warranted to optimize management strategies for this understudied subset of bipolar disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/indianjpsychiatry_412_25","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T15:00:21Z","timestamp":1766070021000},"page":"1187-1190","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Untangling late-onset first-episode mania: A case series"],"prefix":"10.4103","volume":"67","author":[{"given":"Harsh","family":"Khandelwal","sequence":"first","affiliation":[{"name":"Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanyam","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmanpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Institute of Human Behavior and Allied Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh","family":"Nebhinani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, All India Institute of Medical Science, Jodhpur, Rajasthan, 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comorbidities among elderly individuals with bipolar disorder: A literature review","volume":"25","author":"Lala","year":"2012","journal-title":"J Geriatr Psychiatry Neurol"},{"issue":"4 Suppl","key":"R9-20260420","first-page":"1","article-title":"Practice guideline for the treatment of patients with bipolar disorder (revision)","volume":"159","year":"2002","journal-title":"Am J Psychiatry"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.jpsychires.2007.05.003","article-title":"Relationship between age at onset and magnetic resonance image-defined hyperintensities in mood disorders","volume":"42","author":"Takahashi","year":"2008","journal-title":"J Psychiatr Res"}],"container-title":["Indian Journal of 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