COMMENTARY

The Year in Psychiatry: Studies Not to Miss From 2011

Christoph U. Correll, MD; Maren Carbon, MD

Disclosures

November 23, 2011

In This Article

How Prevalent Is Bipolar Disorder?

Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011;68:241-251.

International prevalence rates of bipolar spectrum disorders have differed in earlier studies, raising the possibility of methodologic or true differences. If true differences exists, then contrary to schizophrenia, one might assume a greater weight of sociocultural effects compared with biological factors. In this international household-interview-based survey, Merikangas and colleagues provide data obtained with the same methodology across countries from all continents and as different as Japan, the United States, New Zealand, Romania, and Brazil. The survey involved over 50,000 adults and showed an overall lifetime prevalence of bipolar spectrum disorder of 0.6% for bipolar type I disorder, 0.4% for bipolar type II, 1.4% for subthreshold bipolar, and 2.4% for bipolar syndrome. Notably, compared with other high-income as well as low-income countries, the highest rates of bipolar disorder were recorded in the United States, with a lifetime prevalence of 4.4% and a 12-month prevalence of 2.8%. Of note, 75% of subjects with bipolar disorders were comorbid for additional psychiatric disorders, in particular anxiety disorders. Although 1 in every 4 persons with bipolar type 1 reported at least 1 suicide attempt, appropriate treatment (or at least regular contact with mental health care professionals) was lacking for the majority of affected persons.

This large dataset confirms the construct validity of bipolar disorder across multiple and varied countries and cultures. It further highlights the severity of this serious psychiatric disease and that it is highly comorbid, underrecognized, and undertreated.

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