[The costs of bipolar disorder].
BACKGROUND
According to the estimates of the World Bank and the World Health Organization bipolar disorder is the sixth leading cause of handicap throughout the world. The burden of this disease is similar to the one of schizophrenia. But cost-of-illness studies are too seldom. Although preventive treatments of bipolar disorder are available for more than fifty years, their economic impact has rarely been studied.


RESULTS
This review shows that the yearly cost of bipolar disorder is between 10,000 and 16,000 euro (12,000 and 18,000 US dollars). Eighty percent are indirect costs, 15% are linked to hospitalization and 5% to drugs. Hospitalization costs are lower in Health Maintenance Organization or general population studies than in studies performed on populations receiving care from psychiatric institutions or with a low socio-economic status.


CONCLUSIONS
The use of mood stabilizers has a substantial impact on direct costs which are halved and consequently on indirect costs. But different surveys all agree on the dramatic under-use of mood stabilizers which may be adequately prescribed to only a quarter of bipolar patients.


CONCLUSIONS
Therefore, the optimization of mental health system resources should prompt incentives to better screen, diagnose, and treat patients with a bipolar disorder.
Dardennes
R
R
Université Paris Descartes, Faculté de Médecine Cochin-Port-Royal et CH Sainte-Anne, Paris.
Thuile
J
J
Friedman
S
S
Guelfi
J D
JD
D000927:Anticonvulsants / Q000191:economics; D018692:Antimanic Agents / Q000191:economics; D001714:Bipolar Disorder / Q000191:economics* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D016527:Drug Costs / Q000706:statistics & numerical data; D005060:Europe; D005602:France; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D016896:Treatment Outcome; D014481:United States
D000927:Anticonvulsants; D018692:Antimanic Agents