title: Differences in prevalence and treatment of bipolar disorder among immigrants: results from an epidemiologic survey.
abstract: OBJECTIVE
  To add to the limited data on the prevalence, clinical characteristics, and treatment of bipolar disorder (BD) among immigrants.
  
  
  METHODS
  Data were obtained from a large epidemiologic survey, the Canadian Community Health Survey-Mental Health and Well-Being (CCHS 1.2). Lifetime prevalence rates of BD were compared between immigrant and nonimmigrant respondents. Among BD subjects (n = 831), sociodemographic, clinical, and mental health treatment use variables were compared based on immigrant status. Logistic regression was used to determine the correlates of lifetime contact with a mental health professional and 12-month psychotropic medication use.
  
  
  RESULTS
  Lifetime prevalence rate of CCHS 1.2-defined BD was significantly lower among immigrant, compared with nonimmigrant, participants (1.50% and 2.27%, P = 0.01). There were few sociodemographic or clinical differences, yet immigrants with BD were significantly less likely to report any lifetime contact with mental health professionals (OR = 0.25, 95% CI 0.13 to 0.50, P < 0.001). Past-year psychotropic medication use was numerically lower among immigrants with BD (24.5% and 41.0%); however, this did not reach statistical significance when controlling for other factors (OR = 0.49, 95% CI 0.24 to 1.01, P = 0.05).
  
  
  CONCLUSIONS
  Based on the results of this study, there are in the range of 56 000 to 104 000 immigrants with BD in Canada. Further efforts are needed to better understand and address the barriers to mental health treatment use among immigrants who have BD.
authors: Mood and Anxiety Disorders Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. ayal.schaffer@sunnybrook.ca
authors: Ayal
authors: A
authors: Schaffer
authors: John
authors: J
authors: Cairney
authors: Amy
authors: A
authors: Cheung
authors: Scott
authors: S
authors: Veldhuizen
authors: Paul
authors: P
authors: Kurdyak
authors: Anthony
authors: A
authors: Levitt
mesh_terms: D000086:Acetazolamide; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000628:therapy; D002170:Canada / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012959:Socioeconomic Factors
chemical_list: D011619:Psychotropic Drugs; D000086:Acetazolamide