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Bipolar disorder is a chronic mood disorder with the peak age of onset between 20 and 40 years. The majority of patients have onset prior to age 50. Age of onset can have a significant impact on the etiology, nature and course of the illness. Mania in old age needs a careful assessment for underlying neurological diseases, especially cerebrovascular disease. A 84 year old woman who had complaints of excessive and meaningless talking, irritability, restlessness, anger and insomnia for the first time in her life is presented in this case report. The patient was evaluated and diagnosed as first episode manic attack. Rarity of first manic attack in old age is the significant aspect of the case. Taking notice of items about diagnosing and treating in this kind of patients are discussed in this case report.

Objective: Impulsivity as an important component in the initiation of behavior plays a central role in the pathogenesis of mood disorders, particularly bipolar disorder. The association between bipolar disorder and impulsivity has been clearly presented; however, there are still contradictory findings about the presence of impulsivity in bipolar patients during inter-episodic periods and whether it presents a risk factor for the development of multiple mood episodes (depressive, manic or mixed). The aim of this study was to assess the presence of impulsivity and the relationship with impulsivity-related characteristics in patients with bipolar disorder. Methods: The study was carried out in the Psychiatry Clinics of Çukurova University Faculty of Medicine and Erenköy Training and Research Hospital for Psychiatric and Neurological Diseases. All consecutive patients gave written informed consent. The study group was composed of 60 consecutive bipolar disorder patients (29 female, 31 male) whereas the healthy control group consisted of 60 subjects (32 female, 28 male). The subjects were evaluated by using the Turkish version of the Barratt Impulsivity Scale-11 (BIS-11), Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A), Aggressions Questionnaire (AQ), Spielberger State-Trait Anger Expression Inventory (STAXI) and sociodemographic data form. Results: The two groups were similar to each other in means of gender ratio, age, marital and economical status except for education period. In the bipolar disorder group, the scores of impulsivity, aggression, dimensions of personality and anger were significantly higher than other groups. Correlations between scores of all scales were also significant. Conclusion: The present findings suggest that patients with bipolar disorder still present impulsive traits in interepisodic remission period. There were also significant correlations between impulsivity and other related-characteristics like aggression and anger.