A systematic review of the global distribution and availability of prevalence data for bipolar disorder

Ferrari, Alize J.; Baxter, Amanda J.; Whiteford, Harvey

doi:10.1016/j.jad.2010.11.007

Cited by 90 publications

(63 citation statements)

References 57 publications

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“…13 Further community-and population-based epidemiological studies using ICD and DSM diagnostic criteria estimated the lifetime prevalence of BD as 1.0-2.0%. 14 However, concerns that the prevalence of BD is underestimated in the general population have emerged in the literature. 15 Sequential monitoring of the Zurich cohort 8 found that several episodes of hypomania cannot be readily recognized by traditional criteria and, thus, the authors proposed more flexible criteria for episode duration and number of symptoms required for diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Bipolar disorder prevalence: a systematic review and meta-analysis of the literature

Clemente

Diniz

Nicolato

et al. 2015

Rev. Bras. Psiquiatr.

201

114

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Objective: Bipolar disorder (BD) is common in clinical psychiatric practice, and several studies have estimated its prevalence to range from 0.5 to 5% in community-based samples. However, no systematic review and meta-analysis of the prevalence of BD type 1 and type 2 has been published in the literature. We carried out a systematic review and meta-analysis of the lifetime and 1-year prevalence of BD type 1 and type 2 and assessed whether the prevalence of BD changed according to the diagnostic criteria adopted (DSM-III, DSM-III-R vs. DSM-IV). Methods: We searched MEDLINE, Scopus, Web of Science, PsycINFO, and the reference lists of identified studies. The analyses included 25 population-or community-based studies and 276,221 participants. Results: The pooled lifetime prevalence of BD type 1 was 1.06% (95% confidence interval [95%CI] 0.81-1.31) and that of BD type 2 was 1.57% (95%CI 1.15-1.99). The pooled 1-year prevalence was 0.71% (95%CI 0.56-0.86) for BD type 1 and 0.50% (95%CI 0.35-0.64) for BD type 2. Subgroup analysis showed a significantly higher lifetime prevalence of BD type 1 according to the DSM-IV criteria compared to the DSM-III and DSM-IIIR criteria (p < 0.001). Conclusion: This meta-analysis confirms that estimates of BD type 1 and type 2 prevalence are low in the general population. The increase in prevalence from DSM-III and DSM-III-R to DSM-IV may reflect different factors, such as minor changes in diagnostic operationalization, use of different assessment instruments, or even a genuine increase in the prevalence of BD.

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Section: Introductionmentioning

confidence: 99%

Bipolar disorder prevalence: a systematic review and meta-analysis of the literature

Clemente

Diniz

Nicolato

et al. 2015

Rev. Bras. Psiquiatr.

201

114

View full text Add to dashboard Cite

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“…BPD is present in 1-5% of the worldwide population (Angst, 1998;Ferrari et al, 2011;Merikangas et al, 2007). Patients with either bipolar I or II disorders are more likely to experience depressive rather than manic symptoms over the course of the illness (Judd et al, 2003;Mitchell et al, 2011) and also frequently experience subsyndromal depressive symptoms (Judd et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

A Randomized, Double-Blind, Placebo-Controlled Trial of Pregnenolone for Bipolar Depression

Brown

Park

Marx

et al. 2014

Neuropsychopharmacol

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Depression in bipolar disorder (BPD) is challenging to treat. Therefore, additional medication options are needed. In the current report, the effect of the neurosteroid pregnenolone on depressive symptoms in BPD was examined. Adults (n ¼ 80) with BPD, depressed mood state, were randomized to pregnenolone (titrated to 500 mg/day) or placebo, as add-on therapy, for 12 weeks. Outcome measures included the 17-item Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology-Self-Report (IDS-SR), Hamilton Rating Scale for Anxiety (HRSA), and Young Mania Rating Scale (YMRS). Serum neurosteroid levels were assessed at baseline and week 12. Data were analyzed using a mixed model ANCOVA with a between factor of treatment assignment, a within factor (repeated) of visit, and the baseline value, as well as age and gender, as covariates. In participants with at least one postbaseline visit (n ¼ 73), a significant treatment by week interaction for the HRSD (F(5,288) ¼ 2.61, p ¼ 0.025), but not IDS-SR, was observed. Depression remission rates were greater in the pregnenolone group (61%) compared with the placebo group (37%), as assessed by the IDS-SR (w 2 (1) ¼ 3.99, p ¼ 0.046), but not the HRSD. Large baseline-to-exit changes in neurosteroid levels were observed in the pregnenolone group but not in the placebo group. In the pregnenolone group, baseline-to-exit change in the HRSA correlated negatively with changes in allopregnanolone (r(22) ¼ À 0.43, p ¼ 0.036) and pregNANolone (r(22) ¼ À 0.48, p ¼ 0.019) levels. Pregnenolone was well tolerated. The results suggest that pregnenolone may improve depressive symptoms in patients with BPD and can be safely administered.

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“…Note that this 24% was the prevalence of BD in the general population, not in a specialized clinical population with mood disorder-quite different from the usually reported 12-month and lifetime prevalence figures of 1% to 2% for conservatively diagnosed subjects. 6 In the last few years, there has been growing pushback against such diagnostic inflation from both the medical profession and the general community, 4,7,8 initially in relation to the dramatic increase in the diagnosis of BD in children and adolescents 9 but since then increasingly relating to adult patients. This article will explore these trends and will focus, as much as is possible, on the available evidence.…”

Section: Limitationsmentioning

confidence: 99%

Bipolar Disorder: The Shift to Overdiagnosis

Mitchell

2012

Can J Psychiatry

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Sometimes dramatically changing vogues in diagnostic practice in psychiatry resemble the volatility of international share markets. One such quickly shifting diagnostic area has been that of bipolar disorder (BD). Historically regarded as a relatively uncommon condition until recent decades, the construct of BD underwent a major expansion in the 1990s and 2000s with promulgation of the concept of the soft bipolar spectrum disorder, from which the recent research focus on subthreshold BD presentations was derived. Related to this has been renewed interest in treatments for BD from the pharmaceutical industry. The increasing rates of diagnosis have largely related to BD II, for which there has been a dramatic broadening of diagnostic criteria. This article critically reviews research data, both for broadening the diagnostic criteria for BD and, conversely, for the growing evidence of overdiagnosis in clinical practice. Why does this debate matter? I would suggest that there are many valid reasons to be concerned about overdiagnosis: first, the potential for overtreatment or inappropriate treatment of such patients with mood stabilizing treatments, including antipsychotics; second, the potential for diagnostic oversimplification, with consequent diagnostic deskilling and loss of credibility for the psychiatric profession; and third, the potential major impact on etiologic research for this condition. Psychiatry should not uncritically accept the shift to overdiagnosis, which has developed a rapid momentum in recent decades, in both clinical and academic circles. We must ensure, as a profession, that any change in diagnostic practice is underpinned by rigorous and critical research inquiry. W W WParfois, les modes radicalement changeantes de la pratique du diagnostic en psychiatrie ressemblent à la volatilité des marchés boursiers internationaux. L'un de ces domaines diagnostiques aux changements rapides est celui du trouble bipolaire (TB). Historiquement estimé comme étant une affection relativement peu commune jusqu'aux récentes décennies, le concept du TB a connu une expansion majeure dans les années 1990 et 2000, avec la promulgation du concept du trouble du spectre bipolaire bénin, duquel est dérivée la concentration de la recherche récente sur les présentations infraliminaires du TB. C'est aussi pour cette raison que l'industrie pharmaceutique montre un intérêt renouvelé pour les traitements du TB. Les taux croissants de diagnostics ont été largement liés au TB II, pour lequel il y a eu un élargissement majeur des critères diagnostiques. Cet article se veut une revue critique des données de recherche, tant pour l'élargissement des critères diagnostiques du TB qu'à l'inverse, pour les données probantes croissantes du surdiagnostic dans la pratique clinique. Pourquoi ce débat importe-t-il? Je suggérerais qu'il y a de nombreuses bonnes raisons de s'inquiéter du surdiagnostic : premièrement, le potentiel de surtraitement ou de traitement inapproprié de tels patients par psychorégulateurs, y compris des antipsychot...

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A systematic review of the global distribution and availability of prevalence data for bipolar disorder

Cited by 90 publications

References 57 publications

Bipolar disorder prevalence: a systematic review and meta-analysis of the literature

Bipolar disorder prevalence: a systematic review and meta-analysis of the literature

A Randomized, Double-Blind, Placebo-Controlled Trial of Pregnenolone for Bipolar Depression

Bipolar Disorder: The Shift to Overdiagnosis

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