Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative

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Merikangas, Kathleen R. ^[1] ; Jin, Robert ^[2] ; He, Jian-Ping ; Kessler, Ronald C. ^[2] ; Lee, Sing ^[3] ; Sampson, Nancy A. ^[2] ; Viana, Maria Carmen ^[4] ; Andrade, Laura Helena ^{[4, 5]} ; Hu, Chiyi ^{[6, 7]} ; Karam, Elie G. ^[8] ; Ladea, Maria ^[9] ; Medina-Mora, Maria Elena ^[10] ; Ono, Yutaka ^[11] ; Posada-Villa, Jose ^[12] ; Sagar, Rajesh ^[13] ; Wells, J. Elisabeth ^[14] ; Zarkov, Zahari ^[15]

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^[1] NIMH, Genet Epidemiol Res Branch, Bethesda, MD 20892 - USA

^[2] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 - USA

^[3] Chinese Univ Hong Kong, Prince Wales Hosp, Dept Psychiat, Shatin, Hong Kong - Peoples R China

^[4] Univ Sao Paulo, Sch Med, Sect Psychiat Epidemiol, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Med, Lab Med Invest 23, Inst Psychiat, Sao Paulo - Brazil

^[6] Shenzhen Inst Mental Hlth, Shenzhen - Peoples R China

^[7] Shenzhen Kangning Hosp, Shenzhen - Peoples R China

^[8] Balamand Univ, St George Hosp Univ Med Ctr, Inst Dev Res Advocacy & Appl Care, Med Inst Neuropsychol Disorders, Fac Med, Beirut - Lebanon

^[9] Univ Med & Pharm Carol Davila, Dept Psychiat, Bucharest - Romania

^[10] Natl Inst Psychiat, Mexico City, DF - Mexico

^[11] Keio Univ, Ctr Hlth, Yokohama, Kanagawa 223 - Japan

^[12] Colegio Mayor Cundinamarca Univ, Bogota - Colombia

^[13] All India Inst Med Sci, Dept Psychiat, Delhi - India

^[14] Christchurch Sch Med & Hlth Sci, Christchurch - New Zealand

^[15] Directorate Mental Hlth, Natl Ctr Publ Hlth Protect, Sofia - Bulgaria

• Tipo de documento: Artigo Científico
• Fonte: ARCHIVES OF GENERAL PSYCHIATRY; v. 68, n. 3, p. 241-251, MAR 2011.
• Citações Web of Science: 830

Resumo

Context: There is limited information on the prevalence and correlates of bipolar spectrum disorder in international population-based studies using common methods. Objectives: To describe the prevalence, impact, patterns of comorbidity, and patterns of service utilization for bipolar spectrum disorder (BPS) in the World Health Organization World Mental Health Survey Initiative. Design, Setting, and Participants: Crosssectional, face-to-face, household surveys of 61 392 community adults in 11 countries in the Americas, Europe, and Asia assessed with the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, version 3.0, a fully structured, lay-administered psychiatric diagnostic interview. Main Outcome Measures: Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) disorders, severity, and treatment. Results: The aggregate lifetime prevalences were 0.6% for bipolar type I disorder (BP-I), 0.4% for BP-II, 1.4% for subthreshold BP, and 2.4% for BPS. Twelve-month prevalences were 0.4% for BP-I, 0.3% for BP-II, 0.8% for subthreshold BP, and 1.5% for BPS. Severity of both manic and depressive symptoms as well as suicidal behavior increased monotonically from subthreshold BP to BP-I. By contrast, role impairment was similar across BP subtypes. Symptom severity was greater for depressive episodes than manic episodes, with approximately 74.0% of respondents with depression and 50.9% of respondents with mania reporting severe role impairment. Three-quarters of those with BPS met criteria for at least 1 other disorder, with anxiety disorders (particularly panic attacks) being the most common comorbid condition. Less than half of those with lifetime BPS received mental health treatment, particularly in low-income countries, where only 25.2% reported contact with the mental health system. Conclusions: 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. (AU)

• Processo FAPESP: 03/00204-3 - Estudo epidemiológico dos transtornos psiquiátricos na região metropolitana de São Paulo: prevalências, fatores de risco e sobrecarga social e econômica
• Beneficiário: Laura Helena Silveira Guerra de Andrade
• Modalidade de apoio: Auxílio à Pesquisa - Temático