The replication sample consisted of patients with BD (type I, II or NOS) who were recruited from the outpatient Bipolar Disorders Program of Hospital de Clínicas de Porto Alegre (HCPA) in Brazil. Patients were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV-TR)18. The confirmation of the diagnosis was established by board certified psychiatrists using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I)22. The inclusion criteria of the patients were age from 18 to 65 years old, BD diagnosis according to DSM-IV- TR criteria, and absence of an acute mood episode during the previous month assessed by means of the Hamilton Rating Scale Score (HDRS)23 and the Young Mania Rating Scale (YMRS)24 <15. The AAO of BD was determined retrospectively and was defined as the age at which a patient first met DSM-IV criteria for a major depressive or (hypo)manic episode according to clinical information collected with the SCID-I. The research ethics committee of HCPA approved the study protocol. All subjects provided written informed consent before their inclusion in the study.
