scholarly journals Systematic review of the prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies

2013 ◽  
Vol 35 (2) ◽  
pp. 99-105 ◽  
Author(s):  
José Caetano Dell'Aglio Jr. ◽  
Lissia Ana Basso ◽  
Irani Iracema de Lima Argimon ◽  
Adriane Arteche

This paper describes the findings of a systematic literature review aimed at providing an overview of the lifetime prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies. Databases MEDLINE, ProQuest, Psychnet, and Web of Science were browsed for papers published in English between 1999 and May 2012 using the following search string: bipolar disorders OR bipolar spectrum disorders AND prevalence OR cross-sectional OR epidemiology AND population-based OR non-clinical OR community based. The search yielded a total of 434 papers, but only those published in peer-reviewed journals and with samples aged ≥ 18 years were included, resulting in a final sample of 18 papers. Results revealed rather heterogeneous findings concerning the prevalence of bipolar disorders and bipolar spectrum disorders. Lifetime prevalence of bipolar disorder ranged from 0.1 to 7.5%, whereas lifetime prevalence of bipolar spectrum disorders ranged from 2.4 to 15.1%. Differences in the rates of bipolar disorder and bipolar spectrum disorders may be related to the consideration of subthreshold criteria upon diagnosis. Differences in the prevalence of different subtypes of the disorder are discussed in light of diagnostic criteria and instruments applied.

Author(s):  
Zoltán Rihmer ◽  
Xénia Gonda ◽  
Péter Döme

Bipolar spectrum disorders are among the most frequent psychiatric ailments associated with a considerable risk of suicidal behaviour. Approximately 4–19% of (mostly untreated) patients with bipolar disorders ultimately commit suicide, and about 20–60% of them make at least one suicide attempt in their lifetime. Compared with the general population, the risk of committing suicide is about 10–30 times higher in patients with bipolar disorder. However, the majority of bipolar patients never attempt or commit suicide. Therefore, the routine assessment of several risk factors for suicide in clinical practice may aid in the recognition of those patients who are at the highest risk. This chapter summarizes the clinically most relevant suicide risk and protective factors in bipolar disorders. In addition, we review evidence-based strategies for suicide prevention in bipolar disorder.


2010 ◽  
Vol 59 (4) ◽  
pp. 266-270 ◽  
Author(s):  
Milena S. Castelo ◽  
Eduardo R. Carvalho ◽  
Emília S. Gerhard ◽  
Danielle Silveira Macêdo ◽  
Eduardo D. Ferreira ◽  
...  

OBJECTIVE: Bipolar spectrum disorders (BSDs) are prevalent and frequently unrecognized and undertreated. This report describes the development and validation of the Brazilian version of the bipolar spectrum diagnostic scale (B-BSDS), a screening instrument for bipolar disorders, in an adult psychiatric population. METHOD: 114 consecutive patients attending an outpatient psychiatric clinic completed the B-BSDS. A research psychiatrist, blind to the B-BSDS scores, interviewed patients by means of a modified version of the mood module of the Structured Clinical Interview for DSM-IV ("gold standard"). Subthreshold bipolar disorders were defined as recurrent hypomania without a major depressive episode or with fewer symptoms than those required for threshold hypomania. RESULTS: The internal consistency of the B-BSDS evaluated with Cronbach's alpha coefficient was 0.89 (95% CI; 0.86-0.91). On the basis of the modified SCID, 70 patients (61.4%) of the sample received a diagnosis of BSDs. A B-BSDS screening score of 16 or more items yielded: sensitivity of 0.79 (95% CI; 0.72-0.85), specificity of 0.77 (95% CI; 0.70-0.83), a positive predictive value of 0.85 (95% CI; 0.78-0.91) and a negative predictive value of 0.70 (95% CI; 0.63-0.75). CONCLUSION: The present data demonstrate that the B-BSDS is a valid instrument for the screening of BSDs.


CNS Spectrums ◽  
2010 ◽  
Vol 15 (2) ◽  
pp. 95-109 ◽  
Author(s):  
Icro Maremmani ◽  
Matteo Pacini ◽  
Francesco Lamanna ◽  
Pier Paolo Pani ◽  
Giulio Perugi ◽  
...  

ABSTRACTIndividuals suffering from drug addiction may also manifest features of bipolar spectrum disorders. Hyperthymic and cyclothymic temperaments may render individuals vulnerable to later development of substance abuse. Bipolar disorders themselves may be altered or precipitated by substance use, most notably by stimulants (amphetamines), alcohol, and cannabinoids.The clinical usefulness of mood stabilizers, particularly antiepileptics, has been established as safe and effective in substance abusers with and without comorbid mood disorders. Most studies on this issue have been of short duration and focused on the resolution of a currently manifest period of illness. Few studies have been conducted on the usefulness of these drugs on the long-term longitudinal course of these diseases, such as frequently encountered recurrent relapses into states of agitation, impulsivity, and/or dissatisfaction. As opposed to the clinical experience with traditional antidepressants and neuroleptics, antiepileptics do not induce counter-polar states (depressed patients abruptly turning manic or hypomanic; nor patients currently hypomanic or manic turning abruptly depressed). Many clinicians consider antiepileptic mood stabilizers to be the preferred category of medications for the treatment of such patients. Valproate appears to be a potentially fruitful medication to study in these dual diagnosis patients due to preliminary evidence demonstrating its anticraving efficacy.


Author(s):  
Giulio Emilio Brancati ◽  
Margherita Barbuti ◽  
Alba Calderone ◽  
Paola Fierabracci ◽  
Guido Salvetti ◽  
...  

Abstract Purpose The co-occurrence of obesity, eating and mood disorders has been frequently reported in clinical and epidemiological settings. This study aimed to explore the prevalence of night-eating obese patients referred for bariatric surgery and to identify associated psychopathology and psychiatric comorbidity. Methods The sample was composed of 121 obese patients consecutively enrolled between November 2010 and May 2012 during psychiatric evaluations for bariatric intervention. Clinical features and psychiatric diagnoses were collected. Night-eating was investigated through the administration of the Night-eating Questionnaires (NEQ) and was defined as the presence of self-reported evening hyperphagia and/or nocturnal ingestions. Binge-eating and purging behaviors and general psychopathology were respectively assessed using the Bulimic Investigatory Test, Edinburgh and the Symptom Checklist-90-Revised. Results Night-eating was reported by twenty subjects (16.5%). Patients with night-eating behavior were significantly more frequently diagnosed with bipolar spectrum disorders and with comorbid eating and mood disorders in comparison with other patients. Night-eating patients showed significantly more binging/purging behaviors and greater severity of somatization, obsessive–compulsive symptoms, phobic anxiety, psychoticism and sleep disorders. Patients with bipolar disorder type 1 or 2 scored significantly higher than those without mood disorders at NEQ total score, mood/sleep and nocturnal ingestions subscales, but also scored significantly higher than other patients with mood disorders at the latter subscale. Conclusion Patients with evening hyperphagia and/or nocturnal ingestions should be carefully evaluated to detect possible bipolar spectrum disorders and other eating disorders. Prompt management of these conditions should be provided before bariatric interventions. Level of evidence V, cross-sectional descriptive study.


2010 ◽  
Vol 32 (4) ◽  
pp. 424-428 ◽  
Author(s):  
Milena S. Castelo ◽  
Eduardo R. Carvalho ◽  
Emília S. Gerhard ◽  
Carlos Maurício C. Costa ◽  
Eduardo D. Ferreira ◽  
...  

OBJECTIVE: Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population. METHOD: A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard'). RESULTS: The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95% CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1% of variance. On the basis of the SCID, 69 (60.5%) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95% CI; 0.85-0.98), specificity of 0.70 (95% CI; 0.62-0.75), a positive predictive value of 0.82 (95% CI; 0.75-0.88) and a negative predictive value of 0.84 (95% CI; 0.77-0.90). CONCLUSION: The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).


2016 ◽  
Vol 33 (S1) ◽  
pp. S494-S494
Author(s):  
P. Cano Ruiz ◽  
S. Cañas Fraile ◽  
A. Gómez Peinado ◽  
P. Sanmartin Salinas

IntroductionThe prevalence of obsessive symptoms in bipolar patients is currently under discussion. Last years, different cases of antidepressant-induced mania and hypomania in patients with OCD have been described.Several authors have reported that patients with OCD and bipolar disorder have more depressive episodes than patients with only OCD.ObjectiveTo know the relationship between OCD and other bipolar spectrum disorders.MethodBibliographical review on comorbidity between obsessive symptoms and bipolarity.ResultsSome longitudinal analysis have shown that patients firstly diagnosed with OCD have an increased risk for subsequent diagnosis of all other conditions, especially for bipolar and schizoaffective disorder, for those whose risk is of up to 13 times higher. The handling of a patient with bipolar disorder and OCD implies some difficulty, because of the main treatment of anxiety disorders, the antidepressants, alters the course of manic-depressive illness, accelerating cycles.ConclusionsOCD is etiologically related to bipolar spectrum disorders and schizophrenia. Therefore, it is necessary to continue the investigation of possible involved genes and approaches for clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Mary Fristad ◽  
Elizabeth Nick

This chapter reviews bipolar spectrum disorders (bipolar I, bipolar II, bipolar disorder not otherwise specified, and cyclothymic disorder) in childhood and adolescence. The history of the diagnosis in youth, including recent increased public and professional interest, and surrounding controversy is reviewed. Attention is given to prevalence, incidence, similarities and differences in presentation, course, and comorbidities among child, adolescent, and adult bipolar spectrum disorders. Assessment issues are reviewed, including longitudinal and multiinformant perspectives, instruments, strategies, tools, and assessment challenges with youth. Examples of symptom manifestation in youth are provided. Genetic, cognitive, neuroanatomical, psychosocial, and environmental risks for youth bipolar spectrum disorders are discussed. Evidence-based treatments reviewed include commonly prescribed mood stabilizers and atypical antipsychotics, alternative biological treatments, adjunctive psychotherapies, and complementary and alternative treatments. Finally, future directions for the study, assessment, monitoring, and treatment of youth bipolar spectrum disorders are discussed.


2018 ◽  
Vol 7 (3) ◽  
pp. 471-487 ◽  
Author(s):  
Kasey Stanton ◽  
Shereen Khoo ◽  
David Watson ◽  
June Gruber ◽  
Mark Zimmerman ◽  
...  

Extensive research has been conducted to isolate features that distinguish bipolar spectrum disorders from unipolar depression. Therefore, we identified latent symptom dimensions that are unique versus shared across these disorders by examining the joint structure of hypomanic/manic and depressive symptoms in two large samples (i.e., 647 community adults; 1,370 outpatients with unipolar depression or bipolar disorder history). Results across studies suggested that (a) many hypomanic/manic and depressive symptoms (e.g., irritability) are transdiagnostic, but also that (b) symptoms such as increased energy and euphoric mood define a latent specific positive activation dimension that appears more specific to bipolar disorder. We discuss how these results indicate that some symptoms may be more optimal to target than others when trying to distinguish bipolar disorder from unipolar depression, as well as how the identification of relatively disorder-specific symptom types may optimally guide future research on key mechanisms linked to hypomania/mania and depression.


2020 ◽  
Author(s):  
Benjamin A Katz ◽  
Hadar Naftalovich ◽  
Kathryn Matanky ◽  
Cognition and Psychopathology Lab - Iftah Yovel

Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dual-system theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.


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