Differences between unipolar mania and bipolar-I disorder: Evidence from nine epidemiological studies

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Angst, Jules ^[1] ; Roessler, Wulf ^{[2, 1, 3]} ; Ajdacic-Gross, Vladeta ^[1] ; Angst, Felix ^[4] ; Wittchen, Hans Ulrich ^{[5, 6]} ; Lieb, Rosalind ^{[7, 8]} ; Beesdo-Baum, Katja ^{[5, 9]} ; Asselmann, Eva ^{[5, 9]} ; Merikangas, Kathleen R. ^[10] ; Cui, Lihong ^[10] ; Andrade, Laura H. ^[11] ; Viana, Maria C. ^[12] ; Lamers, Femke ^{[13, 14]} ; Penninx, Brenda W. J. H. ^{[13, 14]} ; Cardoso, Taiane de Azevedo ^[15] ; Jansen, Karen ^[15] ; de Mattos Souza, Luciano Dias ^[15] ; da Silva, Ricardo Azevedo ^[15] ; Kapczinski, Flavio ^{[16, 17]} ; Grobler, Christoffel ^{[18, 19]} ; Gholam-Rezaee, Mehdi ^[20] ; Preisig, Martin ^[20] ; Vandeleur, Caroline L. ^[20]

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^[1] Univ Zurich, Psychiat Hosp, Dept Psychiat Psychotherapy & Psychosomat, Zurich - Switzerland

^[2] Univ Sao Paulo, Inst Psychiat, Lab Neurosci LIM 27, Sao Paulo - Brazil

^[3] Charite Univ Med Berlin, Dept Psychiat & Psychotherapy, Berlin - Germany

^[4] Rehabil Clin, Bad Zurzach - Switzerland

^[5] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, Dresden - Germany

^[6] Ludwig Maximilians Univ Munchen, Psychiat Univ Hosp, Munich - Germany

^[7] Max Planck Inst Psychiat, Munich - Germany

^[8] Univ Basel, Dept Psychol, Div Clin Psychol & Epidemiol, Basel - Switzerland

^[9] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, Behav Epidemiol, Dresden - Germany

^[10] NIMH, Genet Epidemiol Res Branch, Intramural Res Program, Bethesda, MD 20892 - USA

^[11] Univ Sao Paulo, Sch Med, Dept & Inst Psychiat, Sect Psychiat Epidemiol LIM 23, Sao Paulo - Brazil

^[12] Univ Fed Espirito Santo, Postgrad Program Publ Hlth, Dept Social Med, Vitoria, ES - Brazil

^[13] Vrije Univ Amsterdam, Med Ctr, Dept Psychiat, Amsterdam - Netherlands

^[14] Vrije Univ Amsterdam, Med Ctr, Amsterdam Publ Hlth Res Inst, Amsterdam - Netherlands

^[15] Univ Catolica Pelotas, Hlth & Behav Grad Program, Pelotas - Brazil

^[16] Hosp Clin Porto Alegre, Porto Alegre, RS - Brazil

^[17] McMaster Univ, Dept Psychiat & Behav Neurosci, Hamilton, ON - Canada

^[18] Elizabeth Donkin Hosp, Port Elizabeth - South Africa

^[19] Nelson Mandela Univ, Port Elizabeth - South Africa

^[20] Univ Hosp Lausanne, Dept Psychiat, Prilly - Switzerland

• Tipo de documento: Artigo Científico
• Fonte: BIPOLAR DISORDERS; v. 21, n. 5, p. 437-448, AUG 2019.
• Citações Web of Science: 2

Resumo

Objectives Although clinical evidence suggests important differences between unipolar mania and bipolar-I disorder (BP-I), epidemiological data are limited. Combining data from nine population-based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP-I with both manic and depressive episodes with respect to demographic and clinical characteristics in order to highlight differences. Methods Participants were compared for gender, age, age at onset of mania, psychiatric comorbidity, temperament, and family history of mental disorders. Generalized linear mixed models with adjustment for sex and age as well as for each study source were applied. Analyses were performed for the pooled adult and adolescent samples, separately. Results Within the included cohorts, 109 adults and 195 adolescents were diagnosed with M/Md and 323 adults and 182 adolescents with BP-I. In both adult and adolescent samples, there was a male preponderance in M/Md, whereas lifetime generalized anxiety and/panic disorders and suicide attempts were less common in M/Md than in BP-I. Furthermore, adults with mania revealed bulimia/binge eating and drug use disorders less frequently than those with BP-I. Conclusions The significant differences found in gender and comorbidity between mania and BP-I suggest that unipolar mania, despite its low prevalence, should be established as a separate diagnosis both for clinical and research purposes. In clinical settings, the rarer occurrence of suicide attempts, anxiety, and drug use disorders among individuals with unipolar mania may facilitate successful treatment of the disorder and lead to a more favorable course than that of BP-I disorder. (AU)

• Processo FAPESP: 11/50517-4 - Identificação dos diferentes subgrupos de usuários de álcool e fatores associados na região metropolitana de São Paulo: diferenças entre gêneros, dados sociodemográficos e comorbidades psiquiátricas
• Beneficiário: Laura Helena Silveira Guerra de Andrade
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• 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