Approximately 4.4% of Americans have had a diagnosis of bipolar disorder at some time during their lives, compared to a global average of 2.4%, and just 0.1% in India, researchers have revealed in Archives of General Psychiatry. The authors add that even though prevalence rates for bipolar spectrum disorder vary considerably around the globe, the associated disorders and their severities are not significantly different.
Unfortunately, a considerable number of bipolar disorder sufferers do not receive proper treatment, especially in low-income nations.
The authors wrote:
"Bipolar disorder (BP) is responsible for the loss of more disability-adjusted life-years than all forms of cancer or major neurologic conditions such as epilepsy and Alzheimer disease, primarily because of its early onset and chronicity across the life span. Few prior international studies of BP have included information on severity or disability associated with this condition."
Kathleen R. Merikangas, Ph.D., of the National Institute of Mental Health, Genetic Epidemiology Research Branch, Bethesda, Md., and team sought to find out what the prevalence of the disorder might be worldwide. They also aimed to describe its symptom severity, patterns of co-existing illnesses, and service utilization patterns for BPS (bipolar spectrum disorder) in the World Health Organization World Mental Health Survey Initiative. The survey included 61,392 adults from New Zealand, the Lebanon, Japan, India, China, Romania, Bulgaria, Columbia, Brazil, Mexico, and the USA.
The authors wrote:
"In a combined sample of 61,392 adults from 11 countries, the total lifetime prevalences were 0.6 percent for BP-I, 0.4 percent for BP-II, and 1.4 percent for sub-threshold BP, yielding a total BPS prevalence estimate of 2.4 percent worldwide."
They found that depressive episodes were linked to more severe symptoms than manic ones. About 74% of those with depression and 50.9% of those with mania reported severe role impairment.
Approximately three-quarters of respondents with a bipolar spectrum disorder appeared to have at least another disorder as well - they met the criteria for it (them). The most common comorbid conditions were anxiety disorders, particularly panic attacks.
A significant proportion of people worldwide with a BPS do not receive the treatment they need.
The authors wrote:
"Less than half of those with lifetime BPS received mental health treatment, particularly in low-income countries, where only 25.2 percent reported contact with the mental health system."
Experts from the National Institute of Mental Health, Bethesda, USA, who contributed to this study, say more research is required to define the thresholds and boundaries of bipolar symptoms more clearly and accurately. We also need to improve our understanding of why and how BP tends to start during adolescence and persists into adulthood, and how it intersects with comorbid mental disorders.
The researchers stressed that there is an urgent need for access to proper treatment and better recognition of BPS.
"Despite cross-site variation in the prevalence rates of BPS, the severity, impact, and patterns of comorbidity were remarkably similar internationally. The uniform increases in clinical correlates, suicidal behavior, and comorbidity across each diagnostic category provide evidence for the validity of the concept of BPS. Treatment needs for BPS are often unmet, particularly in low-income countries."
What is bipolar disorder?Bipolar disorder, also known as BP, manic-depressive illness or manic depression is a mental illness. The patient experiences instability in mood which is typically serious and disabling. An individual with BP has abnormal shifts in mood, energy, and their ability to function properly is affected - these shifts can go on for weeks, sometimes even months. The general "ups" and "downs" we experience in everyday life have nothing to do with BP. BP symptoms are severe and can destroy relationships, job prospects, and academic performance - put simply, they can ruin a person's life. Symptoms may become so severe that some patients either attempt to or manage to commit suicide.
Fortunately, bipolar disorder is treatable. Millions of patients worldwide manage to lead full and productive lives thanks to effective therapy.
The signs and symptoms of bipolar disorder vary, depending on whether the patient is on a high (mania) or low (depression).
Manic (mania) episodes signs and symptoms can include:
- Aggressive and intrusive behavior
- Agitation and extreme irritability
- Reduced need for sleep
- Refusing to accept that anything is wrong
- Drug abuse, particularly cocaine, alcohol, and sleep aides
- Extremely "high," overly good mood
- Increased drive to perform or achieve goals
- Increased energy, activity, and restlessness
- Increased sexual drive
- Exaggerated self-esteem
- lack of proper judgment
- Rapid speech
- Racing thoughts
- Risky behavior
- Spending sprees
- Tendency to be easily distracted and difficulty concentrating
- Unrealistic beliefs in one's abilities and powers
- Anxiety, overly worried
- Appetite problems
- Concentration problems
- Difficulty making decisions
- Guilt, worthlessness, and helplessness
- Loss of interest in daily activities
- Low libido
- Reduced energy
- Sadness, gloom
- Sensation of emptiness
- Sleeping difficulties
- Suicidal thoughts or behavior
- Unexplained chronic pain
- Unintended weight gain or loss
Kathleen R. Merikangas, PhD; Robert Jin, MA; Jian-Ping He, MD; Ronald C. Kessler, PhD; Sing Lee, MB, BS, FRCPsych; Nancy A. Sampson, BA; Maria Carmen Viana, MD, PhD; Laura Helena Andrade, MD, PhD; Chiyi Hu, MD, PhD; Elie G. Karam, MD; Maria Ladea, MD, PhD; Maria Elena Medina-Mora, PhD; Yutaka Ono, MD; Jose Posada-Villa, MD; Rajesh Sagar, MD; J. Elisabeth Wells, PhD; Zahari Zarkov, MD
Arch Gen Psychiatry. 2011;68(3):241-251. doi:10.1001/archgenpsychiatry.2011.12
Written by Christian Nordqvist