The epidemiology of DSM-III-R bipolar I disorder in a general population survey

Kessler, Ronald C.; Rubinow, David R.; Holmes, Carolyn; Abelson, Jamie M.; Zhao, Shanyang

doi:10.1017/s0033291797005333

Cited by 521 publications

(207 citation statements)

References 54 publications

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“…This may reflect measurement issues related to the CIDI interview. Most past authors have either not reported BD prevalence (12), have qualified their CIDI-derived estimates of BD by excluding some CIDI positive subjects (13), or have presented estimates comparable to the CCHS 1.2 result (14).…”

Section: Resultsmentioning

confidence: 99%

Descriptive Epidemiology of Major Depression in Canada

et al. 2006

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Method: All estimates used appropriate sampling weights and bootstrap variance estimation procedures. The analysis consisted of estimating proportions supplemented by logistic regression modelling. Results:The lifetime prevalence of major depressive episode was 12.2%. Past-year episodes were reported by 4.8% of the sample; 1.8% reported an episode in the past 30 days. As expected, major depression was more common in women than in men, but the difference became smaller with advancing age. The peak annual prevalence occurred in the group aged 15 to 25 years. The prevalence of major depression was not related to level of education but was related to having a chronic medical condition, to unemployment, and to income. Married people had the lowest prevalence, but the effect of marital status changed with age. Logistic regression analysis suggested that the annual prevalence may increase with age in men who never married. Conclusions:The prevalence of major depression in the CCHS 1.2 was slightly lower than that reported in the US and comparable to pan-European estimates. The pattern of association with demographic and clinical variables, however, is broadly similar. An increasing prevalence with age in single (never-married) men was an unexpected finding. Clinical Implications· The CCHS 1.2 replicated several previously reported associations between major depression and demographic and clinical variables. · The lifetime, annual, and point (30-day) prevalences of major depression distribute differently in different age groups. · The association of marital status and sex with major depression differs across different age groups. Limitations· The CCHS 1.2 was a cross-sectional survey. The associations observed do not necessarily reflect causal effects. · While the version of the CIDI used in the CCHS 1.2 is the latest one, few validation data for this interview have been published. · The CIDI is a fully structured interview, making its administration possible by nonclinicians, but it is a crude instrument in the sense that it cannot incorporate clinical judgment.

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Section: Resultsmentioning

confidence: 99%

Descriptive Epidemiology of Major Depression in Canada

et al. 2006

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“…DSM-IV manic episode required 'abnormally and persistently elevated, expansive, or irritable mood.' However, a clinical validation study of community epidemiological data showed that a remarkable 71% of bipolar I DSM diagnoses were false positives, due mostly to citing the 'irritable' option when in fact there was a contextual cause of irritability (Kessler et al 1997). A reanalysis of how to distinguish true cases from false positives led DSM-5 to add a requirement for 'abnormally and persistently increased activity or energy' to manic episode criteria.…”

Section: Dsm-5 False Positives Progressmentioning

confidence: 99%

DSM-5, psychiatric epidemiology and the false positives problem

Wakefield

2015

Epidemiol Psychiatr Sci

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The revision effort leading to the publication of the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was flawed in process, goals and outcome. The revision process suffered from lack of an adequate public record of the rationale for changes, thus shortchanging future scholarship. The goals, such as dimensionalising diagnosis, incorporating biomarkers and separating impairment from diagnosis, were ill-considered and mostly abandoned. However, DSM-5's greatest problem, and the target of the most vigorous and sustained criticism, was its failure to take seriously the false positives problem. By expanding diagnosis beyond plausible boundaries in ways inconsistent with DSM-5's own definition of disorder, DSM-5 threatened the validity of psychiatric research, including especially psychiatric epidemiology. I present four examples: increasing the symptom options while decreasing the diagnostic threshold for substance use disorder, elimination of the bereavement exclusion from major depression, allowing verbal arguments as evidence of intermittent explosive disorder and expanding attention-deficit/hyperactivity disorder to adults before addressing its manifest false positives problems.

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“…For example, more than 60% of people with bipolar disorder meet lifetime criteria for an anxiety disorder (Tamam & Ozpoyraz, 2002), and more than 70% meet lifetime criteria for substance abuse or dependence (Kessler et al, 1997). The role of life events in explaining these comorbid patterns remains unknown.…”

Section: Conceptual Integrationmentioning

confidence: 99%

Life events in bipolar disorder: Towards more specific models

Johnson

2005

Clinical Psychology Review

177

167

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This article reviews the evidence concerning life events as a predictor of symptoms within bipolar disorder. First, key methodological issues in this area are described, and criteria used for including studies in this review are defined. Then findings that negative life events predict worse outcomes within bipolar disorder are reviewed. Beyond general studies on relapse, it is important to differentiate predictors of depression from predictors of mania. When severe negative life events occur, they appear to trigger increases in bipolar depression. Nonetheless, many depressions are unrelated to negative life events and appear to be triggered by other variables. The strongest evidence suggests that negative life events do not trigger mania, except perhaps in certain contexts. Retrospective findings for schedule-disrupting life events as a trigger for manic symptoms await further assessment within a longitudinal study. Life events involving goal attainment do appear to trigger manic symptoms. Overall, it is time to differentiate among specific types of life events, as these different forms of events point towards mechanisms linking stressors with symptom expression. These mechanisms provide clues into ways to integrate the social environment with biological vulnerability (see Bipolar disorder is clearly a biological disorder. Nonetheless, over the past 15 years, a wealth of research has made it abundantly clear that psychosocial variables shape outcomes of this disorder. Much of this psychosocial research has focused on whether life events predict the timing and severity of symptoms within this disorder. This paper reviews the evidence that life events are related to symptom expression within bipolar disorder. This basic question has challenged researchers for over 20 years. Given the growing literature, this paper focus on addressing two more specific questions. Which types of symptoms are related to life events? What types of life events influence symptoms? Given the growing number of studies available on these issues, this review will focus on those studies with the most rigorous methodologies. To set the stage for this endeavor, it is important to first review the major methodological issues in research on life events and bipolar disorder, including issues related to design, measurement, and sampling.

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The epidemiology of DSM-III-R bipolar I disorder in a general population survey

Cited by 521 publications

References 54 publications

Descriptive Epidemiology of Major Depression in Canada

Descriptive Epidemiology of Major Depression in Canada

DSM-5, psychiatric epidemiology and the false positives problem

Life events in bipolar disorder: Towards more specific models

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