Bipolar disorders prevalence

Bipolar disorders have been categorized into bipolar I disorder, bipolar II disorder, and bipolar disorder, not otherwise specified (NOS). Bipolar I disorder is characterized by one or more manic or mixed mood episodes. Bipolar II disorder is characterized by one or more major depressive episodes and at least one hypomanic episode. Hypomania is an abnormally and persistently elevated, expansive, or irritable mood, but not of sufficient severity to cause significant impairment in social or occupational function and does not require hospitalization. Most epidemiologic studies have looked at bipolar disorder of all types (bipolar I and bipolar II), or the bipolar spectrum, which includes all clinical conditions thought to be closely related to bipolar disorder. The lifetime prevalence of bipolar I disorder is estimated to be between 0.3% and 2.4%. The lifetime prevalence of bipolar II disorder ranges from 0.2% to 5%. When including the bipolar spectrum, the lifetime prevalence is between 3% and 6.5%.1... 

Lifetime prevalence rates of psychiatric comorbidity co-existing with bipolar disorder are 42% to 50%.16 Comorbidities, especially substance abuse, make it difficult to establish a definitive diagnosis and complicate treatment. Comorbidities also place the patient at risk for a poorer outcome, high rates of suicidal-ity, and onset of depression.2 Psychiatric comorbidities include ... 

Believed historically to be a relatively rare disorder, large-scale epidemiological research undertaken during the last 20 years indicates that OCD is in fact quite common. The lifetime prevalence of OCD is 2-3%, making it more common, in fact, than bipolar disorder, schizophrenia, and most psychiatric illnesses other than depression and the substance use disorders. 

Adolescent bipolar disorder (BD) was described in the early twentieth century writings of Kraeplin, who noted a significant emergence of BD at puberty (Kraeplin, 1921). It is only within the past decade, however, that adolescent-onset BD has begun to receive significant research attention. Studies estimate the prevalence of bipolar spectrum disorders (e.g., bipolar I, bipolar II, bipolar not otherwise specified) as being 1% in adolescents (Lewinsohn et ah, 1995). In addition, it is estimated that 20%-40% of adults with BD experi-... 

Lewinsohn, P.M., Klein, D.N., and Seeley, J.R. (1995) Bipolar disorder in a community sample of older adolescents prevalence, phenomenology, comorbidity and course./ Am Acad Child Adolesc Psychiatry 34 454-463. 

Overall, the clinical picture of childhood MDD parallels the symptoms of adult MDD (Birmaher et ak, 1996b). There are some developmental differences, however. Symptoms of melancholia (e.g., lack of appetite, insomnia, lack of interest in anything), delusions, suicide attempts, especially high-lethality ones, are all less prevalent in young children and increase with age. In contrast, symptoms of anxiety, behavioral problems, and perhaps auditory and visual hallucinations seem to occur more frequently in children (AA-CAP, 1998 Birmaher et ah, 1996a). Also, it appears that the rate of onset of bipolar disorder is higher in... 

Akiskal, H.S., Bourgeois, M.L., Angst, J., Post, R., Moeller, H.-J., and Hirschfelt, R. (2000) Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord 59 S5—S30. 

Among patients with bipolar disorder, schizophrenia and major depression the prevalence of comorbid substance use disorders may be as high as 50%. Substance use disorders are usually associated with Axis [I (personality) disorders, poor treatment compliance and poorer response to pharmacotherapy exclusion or at least adequate diagnosis of these patients is therefore essential for clinical trials. 

Blumenthal et al. (15) reported that psychotic features in both unipolar and bipolar disorders were indicative of an earlier age of onset and first hospitalization in comparison with their nonpsychotic counterparts. Age of onset for the first episode was found to be earlier in the bipolar group regardless of psychotic categorization. Furthermore, the authors hypothesize that delusional depressions may be related to bipolar disorder, given a higher prevalence of the latter in relatives, and postulate a predictive relationship between psychoticism and bipolarity. 

Bipolar disorder affects about 0.5-1.5% of the U.S. population in any given year. These figures cross cultural, economic, and ethnic boundaries. If broader criteria (i.e., the inclusion of subtypes thought to be variants of bipolar disorder) are applied, its prevalence can reach as high as 5%. Bipolar I disorder (defined below) appears to be equally... 

The lifetime population prevalence of schizophrenia is about 1% (Gottesman, 1989). In a landmark transnational study, similar prevalence w as found for schizophrenia in Africa, Asia, Europe, and the Americas (lablensky and Sartorius, 1988). There is no influence of gender in schizophrenia, w ith w omen as likely to develop this condition as men. Males may have an earlier onset of illness, and a more severe course of illness. Some evidence suggests that the prevalence of schizophrenia may be decreasing over time, w ith few er new cases of the illness reported. The age at onset of schizophrenia is late teens to early tw enties. As in bipolar disorder, the onset of first symptoms after age 40 is rare. 

Bipolar disorder is characterized by episodes of mania or hypomania, which include hyperactivity, decreased need for sleep, and a euphoric or irritable mood. Additionally, persons with bipolar disorder may have episodes of depression similar to those seen in major depressive disorder. The lifetime prevalence of severe bipolar disorder is about 1% and 3-5% if milder cases are included, afflicting men and women equally. Both bipolar disorder and major depressive disorder tend to be episodic, and in the periods of time between episodes, persons may experience few or no symptoms. The etiology of bipolar disorder is predominately genetic, with a 70% concordance in monozygotic twins. The neurobiology of bipolar disorder is less well understood, and few animal models have been developed. Treatment of bipolar disorder usually involves mood stabilizer medications, including lithium, and the anticonvulsants valproate and carbamazepine. At times, antidepressant and antipsychotic medications are also used. 

Beginning with Kraepelin s (1921) systematic classification of dysphoric mania, considerable attention has been paid to mixed states of bipolar disorder. Kraepelin s model was based on variable symptom patterns expressed in three areas, mood, thought, and motor activity. Once considered to be uncommon, current estimates suggest that the prevalence rate for dysphoric, or mixed mania, is approximately 30 percent (McElroy et al. 1992). Debate continues regarding the status of mixed mania as a distinct affective state versus a form, or stage, of typical mania. However, there is convincing evidence to support the opinion that mixed episodes can be more severe, chronic, and difficult to treat than pure manic or depressive episodes (Clothier,... 

Akiskal, H. S. 1996. The prevalent clinical spectrum of bipolar disorders beyond DSM-IV. Journal of Clinical Psychopharmacology 16 (Suppl)4S-14S. 

Freeman MP, Freeman SA, McElroy SL. The comorbidity of bipolar and anxiety disorders Prevalence, psychobiology, and treatment issues. J Affect Disord 2002 68 1-23. 

Bipolar disorder has a lifetime prevalence of approximately 1%. During pregnancy, untreated bipolar disorder may result in hospitalization, suicidal ideation, violence, loss of employment, malnutrition, and an increased risk of postpartum psychosis. It does not appear that pregnancy provides protection for the risk of recurrence of symptoms. Women who discontinue the use of mood stabilizing drugs abruptly before conception or who have had four or more episodes of recurrence of symptoms have a substantial risk for recurrence during pregnancy. Risk for recurrence in the first 3 to 6 months postpartum has been estimated at 20% up to 80%. Postpartum psychosis may occur in 10% to 20% of women with bipolar disorder. 

Psychosis can also occur in what s known as schizoaffective disorder, essentially a symptom-combination of schizophrenia and bipolar disorder seen in some patients. In a recendy conceived diagnostic categorization, schizoaffective disorder is included with schizophrenia, along with related disorders such as schizotypal and schizoid personality disorders, under the umbrella term schizophrenia spectrum disorders. The lifetime prevalence of schizoaffective disorder is less than 1 percent, but the numbers are flexible, since it s often used as a preliminary... 

Patients with bipolar disorder and schizophrenia who are treated with second-generation antipsychotic drugs had similar high rates of the metabolic syndrome in a retrospective comparison of different metabolic parameters [33 f. The prevalence of metabolic syndrome in a matched and randomly selected sample was 43% in bipolar disorder (n = 74) and 46% in schizophrenia (n = 111). 

The increased prevalence of polycystic ovary sjmdrome associated with valproate has been reviewed [386 ]. The risk seems to be higher in women with epilepsy than in women with bipolar disorders, and this might be due to underljdng neuroendocrine dysfunction related to the seizure disorder. 

Dusetzina SB, Weinberger M, Gaynes BN, Farley JF, Sleath B, Hansen RA. Prevalence of bipolar disorder diagnoses and psychotropic drug therapy among privately insured children and adolescents. Pharmacotherapy 2012 32(12) 1085-94. 

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