Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R).
Virtually nothing is known about the epidemiology of rapid cycling bipolar disorder (BPD) in community samples. Nationally representative data are reported here for the prevalence and correlates of a surrogate measure of DSM-IV rapid cycling BPD from the National Comorbidity survey Replication (NCS-R), a national survey of the US household population. DSM-IV disorders were assessed in the NCS-R with the WHO Composite International Diagnostic Interview (CIDI). Although the CIDI did not assess rapid cycling, it did assess the broader category of 12-month BPD with frequent mood episodes (FMEs), having at least four episodes of mania/hypomania or major depression in the 12 months before interview. Roughly one-third of NCS-R respondents with lifetime DSM-IV BPD and half with 12-month BPD met criteria for FME. FME was associated with younger age-of-onset (of BP-I, but not BP-II) and higher annual persistence (73% of the years since first onset of illness with an episode) than non-FME BPD. No substantial associations of FME vs non-FME BPD were found with socio-demographics, childhood risk factors (parental mental disorders, other childhood adversities) or comorbid DSM-IV disorders. However, FME manic episodes had greater clinical severity than non-FME episodes (assessed with a fully structured version of the Young Mania Rating Scale) and FME hypomanic episodes had greater role impairment than non-FME episodes (assessed with the Sheehan Disability Scales). Whether these indicators of severity merely reflect attenuated effects of rapid cycling or independent effects of sub-threshold rapid cycling warrants further study given the high proportion of lifetime cases who met criteria for FME.
Nierenberg
A A
AA
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Akiskal
H S
HS
Angst
J
J
Hirschfeld
R M
RM
Merikangas
K R
KR
Petukhova
M
M
Kessler
R C
RC
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology