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International Similarities Reported in Bipolar Disorders

Treatment needs for bipolar spectrum disorders often unmet, especially in low-income countries

WEDNESDAY, March 9 (HealthDay News) -- Severity, impact, and comorbidity patterns of bipolar spectrum disorders (BPS) are similar internationally, according to a study published in the March issue of the Archives of General Psychiatry.

Kathleen R. Merikangas, Ph.D., from the National Institute of Mental Health in Bethesda, Md., and colleagues assessed the prevalence, impact, and patterns of comorbidity and service utilization in 61,392 adults with BPS. Participants in the World Health Organization World Mental Health Survey Initiative from 11 countries in the Americas, Europe, and Asia, were evaluated using a psychiatric diagnostic interview.

The investigators found that aggregate lifetime and 12-month prevalences were 0.6 and 0.4 percent for bipolar type I disorder (BP-I); 0.4 and 0.3 percent for BP-II; 1.4 and 0.8 percent for subthreshold BP; and 2.4 and 1.5 percent for BPS, respectively. Manic and depressive symptom severity and suicidal behavior increased from subthreshold BP to BP-I with increased symptom severity in depressive episodes compared with manic episodes. Role impairment was similar for all BP subtypes, with severe role impairment identified in 74.0 percent of participants with depression and 50.9 percent with mania. Three-quarters of those with BPS had at least one other comorbid condition, most commonly anxiety disorders (particularly panic attacks). Mental health treatment was received by less than half of those with lifetime BPS and only 25.2 percent of those in low-income countries had contact with the mental health system.

"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," the authors write.

One of the study authors disclosed financial relationships with several pharmaceutical companies that partially funded this study.

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