title: Cross-national prevalence and cultural correlates of bipolar I disorder.
abstract: OBJECTIVE
  Bipolar disorder has been consistently related to heightened sensitivity to reward. Greater reward sensitivity predicts the onset of disorder, a more severe course, and conversion from milder to severe forms. No studies consider whether cultural factors related to reward sensitivity influence the course of bipolar disorder. This study examines the relationship of reward-relevant cultural values to global prevalence rates of bipolar I disorder.
  
  
  METHODS
  Lifetime prevalence of bipolar I disorder for 17 countries was drawn from epidemiological studies that used structured diagnostic interviews of large community samples. Bivariate correlations were used to assess the relationship of bipolar disorder prevalence with national scores on four reward-relevant cultural dimensions (Power Distance, Individualism, Long-Term Orientation, and Performance Orientation).
  
  
  RESULTS
  The prevalence of bipolar I disorder was correlated in the predicted manner with Power Distance and Individualism, and with Long-Term Orientation and Performance Orientation after outliers were removed.
  
  
  CONCLUSIONS
  Findings provide evidence for a cultural model of reward sensitivity in bipolar disorder.
authors.affiliation: University of California, Berkeley, 2205 Tolman Hall, Berkeley, CA, 94720, USA, kjohnson@berkeley.edu.
authors.forename: Kaja R
authors.initials: KR
authors.lastname: Johnson
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011209:Power, Psychological; D015995:Prevalence; D012201:Reward; D055815:Young Adult