Rapid-cycling bipolar disorder: cross-national community study.
BACKGROUND
The epidemiology of rapid-cycling bipolar disorder in the community is largely unknown.


OBJECTIVE
To investigate the epidemiological characteristics of rapid-cycling and non-rapid-cycling bipolar disorder in a large cross-national community sample.


METHODS
The Composite International Diagnostic Interview (CIDI version 3.0) was used to examine the prevalence, severity, comorbidity, impairment, suicidality, sociodemographics, childhood adversity and treatment of rapid-cycling and non-rapid-cycling bipolar disorder in ten countries (n = 54 257).


RESULTS
The 12-month prevalence of rapid-cycling bipolar disorder was 0.3%. Roughly a third and two-fifths of participants with lifetime and 12-month bipolar disorder respectively met criteria for rapid cycling. Compared with the non-rapid-cycling, rapid-cycling bipolar disorder was associated with younger age at onset, higher persistence, more severe depressive symptoms, greater impairment from depressive symptoms, more out-of-role days from mania/hypomania, more anxiety disorders and an increased likelihood of using health services. Associations regarding childhood, family and other sociodemographic correlates were less clear cut.


CONCLUSIONS
The community epidemiological profile of rapid-cycling bipolar disorder confirms most but not all current clinically based knowledge about the illness.
Lee
Sing
S
Hong Kong Mood Disorders Center, Prince of Wales Hospital, Shatin, NT, Hong Kong. singlee@cuhk.edu.hk
Tsang
Adley
A
Kessler
Ronald C
RC
Jin
Robert
R
Sampson
Nancy
N
Andrade
Laura
L
Karam
Elie G
EG
Mora
Maria Elena Medina
ME
Merikangas
Kathleen
K
Nakane
Yoshibumi
Y
Popovici
Daniela Georgeta
DG
Posada-Villa
Jose
J
Sagar
Rajesh
R
Wells
J Elisabeth
JE
Zarkov
Zahari
Z
Petukhova
Maria
M
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology*; D016241:Child of Impaired Parents; D003527:Cyclothymic Disorder / Q000175:diagnosis / Q000453:epidemiology; D017579:Domestic Violence / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008426:Maternal Deprivation; D008875:Middle Aged; D010333:Paternal Deprivation; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010507:Periodicity; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult