title: The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members.
abstract: Members of the National Depressive and Manic-Depressive Association who have bipolar disorder were surveyed. 59% of respondents had their first symptoms during childhood or adolescence. Long delays between symptom onset, treatment-seeking, and receipt of a bipolar diagnosis were common. 45% of respondents currently experience frequent recurrences. Child/adolescent onset was associated with a positive family history, depressive or mixed initial symptoms, and frequent recurrence, with predominantly depressive symptoms. Frequent recurrences were associated with depressive or mixed initial symptoms and depressive episodes, but not with medication non-compliance. Both child/adolescent onset and frequent recurrence were associated with increased social morbidity, which was diminished by effective treatment. Respondents with frequent recurrences were less likely to be treated with mood-stabilizers, more likely to be treated with anti-depressants, or anxiolytics, and more likely to report past anxiety symptoms and diagnoses. 13% of respondents had no medical insurance, and 15% had failed to take medicine for financial reasons. The treatment of bipolar illness could be enhanced by (a) public health efforts to promote early diagnosis and treatment; (b) ensuring adequate trials of mood-stabilizers for patients with frequent recurrences; (c) further research on bipolar disorder with prominent anxiety symptoms; and (c) improved access to mental health care.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia 19104-6021.
authors.forename: J D
authors.initials: JD
authors.lastname: Lish
authors.forename: S
authors.initials: S
authors.lastname: Dime-Meenan
authors.forename: P C
authors.initials: PC
authors.lastname: Whybrow
authors.forename: R A
authors.initials: RA
authors.lastname: Price
authors.forename: R M
authors.initials: RM
authors.lastname: Hirschfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology / Q000534:rehabilitation; D002648:Child; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology / Q000534:rehabilitation; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D011788:Quality of Life; D012008:Recurrence; D012917:Social Adjustment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D011619:Psychotropic Drugs