Rapid-cycling bipolar disorder: cross-national community study

Br J Psychiatry. 2010 Mar;196(3):217-25. doi: 10.1192/bjp.bp.109.067843.

Abstract

Background: The epidemiology of rapid-cycling bipolar disorder in the community is largely unknown.

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

Method: 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.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Anxiety Disorders / epidemiology*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology*
  • Child of Impaired Parents*
  • Cyclothymic Disorder / diagnosis
  • Cyclothymic Disorder / epidemiology
  • Domestic Violence / statistics & numerical data
  • Epidemiologic Methods
  • Female
  • Humans
  • Life Change Events*
  • Male
  • Maternal Deprivation
  • Middle Aged
  • Paternal Deprivation
  • Patient Acceptance of Health Care / statistics & numerical data
  • Periodicity*
  • Prevalence
  • Substance-Related Disorders / epidemiology
  • Young Adult