Rapid-cycling bipolar disorder: cross-national community study

S Lee, A Tsang, R. C Kessler, R Jin, N Sampson, L Andrade, E. G Karam, M. E. M Mora, K Merikangas, Y Nakane, D. G Popovici, J Posada Villa, R Sagar, J. E Wells, Z Zarkov and M. Petukhova

The British Journal of Psychiatry, 2010, 196(3), 217-225. 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.

ASCI-ID: 1409-184