title: Rapid-cycling bipolar disorder: cross-national community study.
abstract: 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.
authors.affiliation: Hong Kong Mood Disorders Center, Prince of Wales Hospital, Shatin, NT, Hong Kong. singlee@cuhk.edu.hk
authors.forename: Sing
authors.initials: S
authors.lastname: Lee
authors.forename: Adley
authors.initials: A
authors.lastname: Tsang
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Robert
authors.initials: R
authors.lastname: Jin
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.forename: Laura
authors.initials: L
authors.lastname: Andrade
authors.forename: Elie G
authors.initials: EG
authors.lastname: Karam
authors.forename: Maria Elena Medina
authors.initials: ME
authors.lastname: Mora
authors.forename: Kathleen
authors.initials: K
authors.lastname: Merikangas
authors.forename: Yoshibumi
authors.initials: Y
authors.lastname: Nakane
authors.forename: Daniela Georgeta
authors.initials: DG
authors.lastname: Popovici
authors.forename: Jose
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sagar
authors.forename: J Elisabeth
authors.initials: JE
authors.lastname: Wells
authors.forename: Zahari
authors.initials: Z
authors.lastname: Zarkov
authors.forename: Maria
authors.initials: M
authors.lastname: Petukhova
mesh_terms: 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