Whatever the reason, it's clear that bipolar disorder takes a big toll on Americans' health. Without appropriate treatment - often antidepressant medication in conjunction with counseling - the shifting moods and energy levels, distractibility, restlessness, disturbed sleep, and other hallmarks of the illness can affect relationships, job performance, and even the ability to carry out day-to-day tasks.
Ryan Jaslow. Please enter email address to continue. Please enter valid email address to continue. Chrome Safari Continue. The mean ages at onset were 18 years for bipolar disorder type I, 20 years for bipolar disorder type II, and 22 years for subthreshold bipolar disorder. Patterns of comorbidity were remarkably consistent among the different countries. Three-fourths of patients with bipolar spectrum disorders also met criteria for other psychiatric disorders, and the majority had three or more of them.
Merikangas and her colleagues said Arch. Psychiatry ; The association between bipolar disorders and substance use disorders across the globe was particularly striking in light of the large differences between countries in rates of substance use and abuse. The proportion of patients with suicidal behaviors rose with increasing severity of bipolar disease. This "striking" finding of suicidality, together with the early age at onset and the strong association with other mental health disorders, provides "further documentation of the individual and societal disability associated with this disorder," they noted.
First, the surveys are cross-sectional, so the findings are based on retrospective recall of symptoms, age at onset, and clinical correlates. Such recall bias may differ by variation in the age composition across countries. Second, despite the use of common interview and diagnostic methods, there was still substantial cross-national variation in the rates of BPS. Although it is possible that these differences reflect real variation in prevalence perhaps owing to higher false-negatives in countries with greater stigma associated with mental illness, further inspection of these differences suggested that there was also variation in the translation, implementation, and quality control in some countries that may have led to reduced prevalence rates.
Because there were major cross-country differences in social structure, we could not adequately control for social status, income, educational level, and other potentially relevant correlates of mental disorders. Fourth, the lack of information on mixed episodes of BP may have led to inaccurate estimates of the aggregate prevalence of either BP or major depression.
There are also several features of the WMH Survey Initiative that represent advances over prior cross-national studies in psychiatric epidemiology. First, the WMH initiative includes a far larger representation of several regions of the world, including low-income countries. Second, the high degree of coordination across studies enhanced the validity of the cross-national comparisons. Third, the inclusion of standardized methods for assessing severity and role impairment facilitates estimation that can provide a context for the public health significance of the prevalence estimates.
These findings demonstrate the important growth of international collaborations that permit investigation of cultural and regional differences in prevalence and risk factors for mental disorders.
Recent efforts such as the proposal of a common global nomenclature to define the course and outcome in BPs as proposed by a task force under the auspices of the International Society for Bipolar Disorders 43 should facilitate outcome studies across geographic areas. Contemporary issues concerning BP that warrant further study include the following: further evaluation of the thresholds and boundaries of BP; better integration of adult and child epidemiology of BP and its evolution in light of its onset in adolescence; and further investigation of explanations for the patterns of comorbidity between BP and other disorders.
In summary, this article reports the first data, to our knowledge, on the prevalence and correlates of the full spectrum of BP in a series of nationally representative surveys using common methods. As such, it documents the magnitude and major impact of BP worldwide and underscores the urgent need for increased recognition and treatment facilitation.
Correspondence: Kathleen R. Submitted for Publication: May 16, ; final revision received November 17, ; accepted November 19, Alden Trust. Disclaimer: The views and opinions expressed in this article are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or US government. We thank the WMH staff for assistance with instrumentation, fieldwork, and data analysis. Our website uses cookies to enhance your experience.
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Privacy Policy Terms of Use. This Issue. Citations 1, View Metrics. Twitter Facebook More LinkedIn. Original Article. March 7, Kathleen R. Bp disorders. Other disorders. Clinical reappraisal of cidi disorder. Other measures. Statistical analysis.
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