Statistics of bipolar disorder
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Statistics of Bipolar Disorder
Prevalence of Bipolar Disorder
Global and Regional Prevalence
Bipolar disorder (BPD) affects a significant portion of the global population. In European countries, the 12-month prevalence of bipolar I and II disorders is approximately 1%, with a lifetime incidence ranging from 1.5% to 2%1. When considering the broader bipolar spectrum, the prevalence increases to around 6%1. In the United States, the lifetime prevalence of the bipolar spectrum, including subthreshold cases, is estimated at 6.4%7. The Global Burden of Disease Study 2017 reported that the incidence of BPD increased from 3.06 million in 1990 to 4.53 million in 2017, with a slight increase in age-standardized incidence and disability-adjusted life years (DALYs)8.
Pediatric Bipolar Disorder
Pediatric bipolar disorder (PBD) remains a controversial diagnosis. A meta-analysis suggested a global community prevalence of 1.8%, later updated to 3.9%2 3 4. However, narrative analyses argue that the actual rates are substantially lower, particularly in non-US samples, where rates can be close to zero for pre-adolescents2 3 5. The diagnosis of PBD often does not correlate with adult bipolar disorder, and hypomanic syndromes in adolescence may not progress to adult bipolar disorder2 3.
Comorbidity and Disability
Comorbidity with Other Disorders
Bipolar disorder frequently coexists with other mental health conditions. Anxiety disorders are particularly common, with a lifetime prevalence of 45% in individuals with bipolar disorder, which is three times higher than in the general population9. Additionally, there is a high degree of concurrent and sequential comorbidity with other mental disorders and physical illnesses1.
Disability and Service Utilization
Individuals with bipolar disorder experience significant impairments and disabilities. In Australia, 69.6% of individuals with bipolar disorder reported recurrent episodic illness, and 25% had a chronic course without clear remissions6. Suicidal ideation is common, with 78.6% reporting such thoughts, and 32.1% experiencing drug and alcohol abuse or dependence6. Despite high levels of service utilization, many individuals report unmet service needs and a poorer quality of life6. Comparisons with schizophrenia patients indicate that while bipolar patients may have less chronic impairment, their service utilization is equal to or greater6.
Suicide Risk
Predictors of Suicide
Bipolar disorder is associated with high rates of suicide attempts and completions. A study following 1,556 patients with bipolar disorder for up to two years found that a history of suicide attempts and the percentage of days depressed in the past year were significant predictors of future suicide attempts and completions10. Patients with a history of suicide attempts were over four times more likely to have a subsequent attempt or completion10.
Conclusion
Bipolar disorder is a prevalent and disabling condition with significant comorbidity and a high risk of suicide. The prevalence varies globally, with notable differences in pediatric diagnoses. Effective management and early diagnosis are crucial to mitigate the substantial burden on individuals and healthcare systems. Further research is needed to refine diagnostic criteria and improve treatment strategies, particularly for pediatric cases and those with comorbid conditions.
Sources and full results
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 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-Analysis
Rigorous Journal‘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 previously reported, and early diagnosis is crucial, but overdiagnosis may have adverse consequences.
Meta-AnalysisRigorous JournalUpdated 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 Cited‘Paediatric bipolar disorder’ rates are lower than claimed – a reexamination of the epidemiological surveys used by a meta‐analysis
Paediatric bipolar disorder rates are significantly lower than previously claimed, particularly in non-US surveys, and are rare before the expected age of onset in later adolescence.
Meta-AnalysisThe epidemiology of bipolar disorder: sociodemographic, disability and service utilization data from the Australian National Study of Low Prevalence (Psychotic) Disorders.
Bipolar disorder is associated with high social disablement and significant gaps in service provision, despite low chronicity.
Observational StudyHighly CitedThe prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases.
The bipolar spectrum has a high prevalence in the US population, with subthreshold cases being at least five times more prevalent than DSM-based core syndromal diagnoses, affecting marital disruption, health service utilization, and suicidal behavior.
Observational StudyHighly CitedTrends in the incidence and DALYs of bipolar disorder at global, regional, and national levels: Results from the global burden of Disease Study 2017.
Bipolar disorder incidences and DALYs have increased globally, despite stable ASIR and ASDR rates, resulting in a growing burden on health-care systems.
Observational StudyLifetime prevalence of anxiety disorders in people with bipolar disorder: a systematic review and meta-analysis.
Nearly one in two individuals with bipolar disorder has an anxiety disorder in their lifetime, highlighting the need for anxiety disorders to be assessed alongside mood symptoms.
Meta-Analysis
Very Rigorous JournalHighly CitedProspective predictors of suicide and suicide attempts in 1,556 patients with bipolar disorders followed for up to 2 years.
Patients with bipolar disorder who have a history of suicide attempts are over four times as likely to have a subsequent suicide attempt or completion.
Observational StudyHighly Cited