title: A multicenter study of bipolar disorder among emergency department patients in Latin-American countries.
abstract: OBJECTIVE
  This multicenter study estimated the prevalence of bipolar disorder (BPD) among emergency department (ED) patients in Latin America.
  
  
  METHODS
  To identify patients with BPD, a combination of DSM IV-criteria interview and the Mood Disorder Questionnaire (MDQ) was used. Data from 1,505 patients from hospitals in Argentina, Brazil, Chile, Colombia, and Mexico was analyzed.
  
  
  RESULTS
  The prevalence ofBPD in this sample was 5.2% (95% CI = 4.5% to 6.9%). The mean age was 37 years (response rate of 83.0%). Compared to non-BPD patients, BPD patients were more likely to report asthma (16.7% vs. 9%), thyroid problems (12.8% vs. 5.8%), seizures (23.1% vs. 3.0%), obesity (39.7% vs. 26.9%), alcohol abuse (30.8% vs. 10.0%), attention deficit hyperactivity disorders (50.0% vs. 12.0%), depression (81.6% vs. 45.7%), obsessive compulsive disorder (20.1% vs. 3.0%), panic disorders (23.1% vs. 12.3%), phobic disorders (11.2% vs. 3.1%), and any anxiety disorder (82.1 % vs. 41.8%; all p < or = 0.05). Suicidal plans and attempts were also significant higher in the bipolar group (11.5% vs. 2.8% and 10.3% vs. 1.8% respectively). Multivariate analysis identified ADHD, depression, alcohol abuse, anxiety disorder, and last month suicide plans and attempts to be independently associated with BPD.
  
  
  CONCLUSIONS
  Our study supports that BPD is prevalent in ED in Latin-American countries and that comorbidity is the rule, not the exception. Patients presenting at ED with irritability, anxiety, pressure speech, euphoria, with suicidal tendencies, involved in risky behaviors, alcohol abuse, dependence or those with history of mental health hospitalization in the past 12 months must be assessed for comorbid BPD.
authors.affiliation: University of North Carolina at Chapel Hill, USA. castilla@temple.edu
authors.forename: Ruby
authors.initials: R
authors.lastname: Castilla-Puentes
authors.forename: Ricardo
authors.initials: R
authors.lastname: Secin
authors.forename: Arturo
authors.initials: A
authors.lastname: Grau
authors.forename: Roxanna
authors.initials: R
authors.lastname: Galeno
authors.forename: Marcelo Feijo
authors.initials: MF
authors.lastname: De Mello
authors.forename: Sandra
authors.initials: S
authors.lastname: Castilla-Puentes
authors.forename: Wilma
authors.initials: W
authors.lastname: Castilla-Puentes
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Sanchez-Russi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007843:Latin America; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult