Under-reporting bipolar disorder in large-scale epidemiologic studies

Autor(es)

Karam, Elie G. ^{[1, 2]} ; Sampson, Nancy ^[3] ; Itani, Lynn ^[1] ; Andrade, Laura Helena ^[4] ; Borges, Guilherme ^{[5, 6]} ; Chiu, Wai Tat ^[3] ; Florescu, Silvia ^[7] ; Horiguchi, Itsuko ^[8] ; Zarkov, Zahari ^[9] ; Akiskal, Hagop ^[10]

Afiliação do(s) autor(es)

^[1] Inst Dev Res Advocacy & Appl Care IDRAAC, Beirut - Lebanon

^[2] Balamand Univ, St George Hosp, Dept Psychiat & Clin Psychol, Univ Med Ctr, Fac Med, Beirut 11002110 - Lebanon

^[3] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 - USA

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

^[5] Metropolitan Autonomous Univ, Mexico City, DF - Mexico

^[6] Natl Inst Psychiat Mexico, Div Epidemiol & Psychosocial Res, Mexico City, DF - Mexico

^[7] Natl Sch Publ Hlth Management & Profess Dev, Bucharest - Romania

^[8] Juntendo Univ, Fac Med, Tokyo - Japan

^[9] Natl Ctr Publ Hlth & Anal, Dept Mental Hlth, Sofia - Bulgaria

^[10] Univ Calif San Diego, Int Mood Ctr, La Jolla, CA 92093 - USA

• Tipo de documento: Artigo Científico
• Fonte: Journal of Affective Disorders; v. 159, p. 147-154, APR 2014.
• Citações Web of Science: 10

Resumo

Background: To investigate if the prevalence of bipolar disorder in epidemiologic studies is an underestimate, as suggested by clinical studies. Methods: We analyzed data from 8 countries that participated in the World Mental Health Survey Initiative (n=47,552). We identified 6.8% and 18.9% of the sample who we think were screened out inappropriately (SCI) from the euphoric and irritable bipolar sections respectively. We compared them to those who were allowed to continue the section (CONT, 2.6% of the sample for euphoric; 1.0% for irritable) and to the reference group (REF, 69.5% of the sample). Results: The SCI group had consistently higher rates of major depression (29.1% vs. GA%), earlier age of onset (24.3 y vs. 32.4 y), more suicide attempts (13.3% vs. 5.9%), and more episodes (4.2 vs. 2.7) than the REF for the euphoric group. Similar findings exist for the irritable group. Also, comorbidity with anxiety, disruptive behavior disorders and substance use were much higher than the REF. Limitations: As with all epidemiologic studies, recall bias cannot be ruled out. Conclusions: The findings above suggest that a number of the SCI subjects belong to the bipolar group. A revision of instruments used in epidemiologic research will probably prove what clinical studies have been showing that bipolar disorder is more common than has been reported. (C) 2014 Elsevier B.V. All rights reserved, (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