Prevalence of bipolar disorder
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Prevalence of Bipolar Disorder: A Global Perspective
Prevalence of Bipolar Disorder in Europe
In European countries, the prevalence of bipolar disorder (BD) has been extensively studied. The majority of studies report a 12-month prevalence of approximately 1%, with a range from 0.5% to 1.1% 1. The cumulative lifetime incidence is slightly higher, ranging from 1.5% to 2%, and when considering the broader bipolar spectrum disorders, the prevalence increases to around 6% 1. These studies indicate that there is little evidence of gender differences in the prevalence of BD. The age of onset is typically in late adolescence or early adulthood, and there is a high degree of comorbidity with other mental and physical disorders 1.
Bipolar Disorder Prevalence in China
A meta-analysis of studies conducted in China reveals significantly lower prevalence rates compared to Western countries. The point prevalence of BD in China is estimated at 0.09%, the 12-month prevalence at 0.17%, and the lifetime prevalence at 0.11% 2. For BD-I, the point prevalence is 0.06%, the 12-month prevalence is 0.08%, and the lifetime prevalence is 0.09%. For BD-II, both the point and lifetime prevalence rates are 0.04% 2. Interestingly, the 12-month prevalence of BD has increased significantly after 2010, suggesting a potential rise in recognition or diagnosis of the disorder 2.
Bipolar Disorder in Perinatal Women
The perinatal period is associated with a higher prevalence of bipolar-spectrum mood episodes. In women with no prior psychiatric illness, the pooled prevalence of BD during the perinatal period is 2.6%, while the prevalence of bipolar-spectrum mood episodes during pregnancy and postpartum is 20.1% 3. For women with a prior diagnosis of BD, 54.9% experience at least one bipolar-spectrum mood episode during the perinatal period 3. This highlights the perinatal period as a high-risk time for mood episodes in women with BD.
Global Distribution and Availability of Prevalence Data
A systematic review of global prevalence data for bipolar spectrum disorders (BSD) indicates a mean pooled point prevalence of 0.741% and a 6/12-month prevalence of 0.843% 4. The study region, response rate, and diagnostic tools significantly impact prevalence estimates, but there are no significant differences across gender, economic status, or bipolar subtype 4. This review underscores the variability in prevalence data and the need for more comprehensive global studies.
Pediatric Bipolar Disorder
The prevalence of pediatric bipolar disorder (PBD) remains a contentious issue. Earlier meta-analyses suggested a global community prevalence of 1.8%, which was later updated to 3.9% with additional surveys 57. However, narrative analyses argue that the actual rates are substantially lower, particularly in pre-adolescent populations where rates are close to zero 5. The prevalence of adolescent hypomania/mania is higher, but most cases do not progress to adult bipolar disorder 5. This suggests that PBD is rare and that early diagnosis should be approached with caution to avoid over-diagnosis and potential iatrogenic consequences 57.
Bipolar Disorder Prevalence in the United States
In the United States, the 12-month prevalence of bipolar I disorder is 2.0%, and the lifetime prevalence is 3.3% 9. There are no significant sex differences in prevalence, but certain demographic groups, such as Native Americans and younger adults, show higher odds of having BD 9. The disorder is highly comorbid with substance use, anxiety, and personality disorders, but not with alcohol abuse 9.
Conclusion
The prevalence of bipolar disorder varies significantly across different regions and populations. European countries report a 12-month prevalence of around 1%, while China shows much lower rates. The perinatal period is a high-risk time for mood episodes in women with BD. Pediatric bipolar disorder is rare, and its diagnosis should be approached cautiously. In the United States, the prevalence is higher than previously estimated, with significant comorbidity with other mental health disorders. These findings highlight the importance of region-specific studies and the need for consistent diagnostic criteria to better understand the global burden of bipolar disorder.
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Most relevant research papers on this topic
Prevalence and burden of bipolar disorders in European countries
Bipolar disorders have a prevalence of approximately 1% in European countries, with a high degree of comorbidity and impairments, similar to major depression and schizophrenia.
Systematic Review
Highly CitedThe prevalence of bipolar disorder in China: A meta-analysis.
Bipolar disorder prevalence rates in China are generally lower than those reported in Western countries, with younger age being associated with higher rates.
Meta-Analysis
Rigorous JournalPrevalence of Bipolar Disorder in Perinatal Women: A Systematic Review and Meta-Analysis.
The perinatal period is associated with high rates of bipolar-spectrum mood episodes, making pregnant and postpartum women a special risk population.
Meta-AnalysisA systematic review of the global distribution and availability of prevalence data for bipolar disorder.
This systematic review provides a mean pooled prevalence of 0.741% for bipolar disorder, with study region, response rate, and diagnostic tool significantly impacting estimates, but no significant differences across prevalence types, gender, sample coverage, economic status, and bipolar subtype.
Systematic ReviewHighly Cited‘Pediatric Bipolar Disorder’ rates are still lower than claimed: a re-examination of eight epidemiological surveys used by an updated meta-analysis
Bipolar disorder is very rare in childhood and adolescence, with 'pediatric bipolar disorder' rates being lower than claimed, and hypomanic syndromes in adolescence may not progress to adult bipolar disorder.
Meta-AnalysisRigorous JournalBipolar disorder prevalence: a systematic review and meta-analysis of the literature.
Bipolar disorder prevalence estimates are low in the general population, with the increase in prevalence from DSM-III and DSM-III-R to DSM-IV possibly reflecting minor changes in diagnostic operationalization or a genuine increase in the disorder.
Meta-AnalysisRigorous JournalHighly CitedUpdated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder.
Pediatric bipolar disorder prevalence rates are not higher in the United States than in other Western countries, and rates are not increasing over time.
Meta-AnalysisHighly CitedMeta-analysis of epidemiologic studies of pediatric bipolar disorder.
Pediatric bipolar disorder rates are higher than commonly acknowledged, but not significantly different between US and non-US samples, and there is no evidence of an increase in community rates over time.
Meta-AnalysisHighly CitedPrevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
Bipolar I disorder is more prevalent in the U.S. population than previously estimated, with significant associations to substance use, anxiety, and personality disorders, but not alcohol abuse.
Observational StudyHighly CitedRe-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders.
Bipolar disorder has a higher prevalence of up to 5% in the general population, with'softer' clinical expressions accounting for 30-55% of all major depressions.
Highly Cited