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Bipolar Affective Disorder
 
EPIDEMIOLOGY OF BIPOLAR DISORDER

The Epidemiological Catchment Area Study (Regier et al, 1988) indicates that Bipolar I and II disorders combined are more common than previously thought. Akiskal (1996) presents a persuasive argument for considering the diagnosis of hypomania even if it is present for 1-2 days, and not at least 4 days as required in DSM IV. If this approach is adopted, Bipolar II disorder will have a much greater prevalence than hitherto considered and will certainly broaden the concept of bipolar disorder. The National Comorbidity Survey (Kessler et al, 1994) reported a lifetime prevalence of mania of 1.6% compared with 0.6% for non-affective psychoses.

Alcohol and substance abuse are common comorbid, masking and complicating conditions in the presence of bipolar disorder, and most of the research on treatment outcome in bipolar disorder has not included these groups of patients thus making it difficult to extrapolate the results of research treatment outcome studies to this clinical population. There is an established association between cocaine abuse and underlying bipolar disorder.

References
Akiskal HS. The Prevalent Clinical Spectrum of Bipolar Disorders: Beyond DSM-IV. J. Clin Psychopharm. 1996. 16: 2. Suppl 1. 4S-14S

Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS. Lifetime and 12 Month Prevalence of DSM-III R Psychiatric Disorders in the USA: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994. 51: 8-19.

Regier DA, Boyd JH, Rae DS, Burke JD, Locke BZ, Myers JK, Kramer M, Robins LN, George LK, Karno M. One-month Prevalence of Mental Disorders in the United States: Based on Five Epidemiologic Catchment Area Sites. Arch Gen Psychiatry. 1988. 45: 977-986.

 

 


Over one million Canadians suffer from some form of depressive illness.