The lifetime prevalence of bipolar disorders and the use of antidepressant drugs in bipolar depression in Italy

Abstract

Background: The prevalence of bipolar spectrum disorders in the community is under debate and the prescription of antidepressant drugs (ADs) in bipolar depression appears to be an underestimated problem.

Objectives: To evaluate the prevalence of bipolar disorders by means of a screening instrument in seven communities within six regions of Italy and evaluate the appropriateness and number of prescriptions for ADs in bipolar depression.

Study design: community survey.

Study population: samples randomly drawn, after stratification from the adult population of municipal records.

Sample size: 4999 people from seven communities within six regions of Italy. Tools: questionnaire on psychotropic drug consumption, prescription, health services utilization; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Mood Disorder Questionnaire (MDQ). Training: interviewers were trained psychologists or medical doctors.

Study limitations: the population studied did not represent a nationally representative multistage clustered area probability sample of households.

Results: 3398 subjects were interviewed (68% of recruited sample). Positivity at MDQ (MDQ+) was higher in males (3.4% vs. 2.8%) but the difference was not significant (OR=1.2, P=0.37). The association between MDQ+ and Major Depressive Disorder (MDD) was statistically significant for both males (OR=14.9, P<0.0001) and females (OR=8.3, P<0.001); 30% of subjects with MDQ+ and MDD lifetime diagnosis were taking ADs.

Conclusions: These overall rates of being MDQ+ are similar to community surveys conducted within USA and the use of ADs in people with MDQ+ and MDD diagnoses are.