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- Title
Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R).
- Authors
Nierenberg, A. A.; Akiskal, H. S.; Angst, J.; Hirschfeld, R. M.; Merikangas, K. R.; Petukhova, M.; Kessler, R. C.
- Abstract
Virtually nothing is known about the epidemiology of rapid cycling bipolar disorder (BPD) in community samples. Nationally representative data are reported here for the prevalence and correlates of a surrogate measure of DSM-IV rapid cycling BPD from the National Comorbidity survey Replication (NCS-R), a national survey of the US household population. DSM-IV disorders were assessed in the NCS-R with the WHO Composite International Diagnostic Interview (CIDI). Although the CIDI did not assess rapid cycling, it did assess the broader category of 12-month BPD with frequent mood episodes (FMEs), having at least four episodes of mania/hypomania or major depression in the 12 months before interview. Roughly one-third of NCS-R respondents with lifetime DSM-IV BPD and half with 12-month BPD met criteria for FME. FME was associated with younger age-of-onset (of BP-I, but not BP-II) and higher annual persistence (73% of the years since first onset of illness with an episode) than non-FME BPD. No substantial associations of FME vs non-FME BPD were found with socio-demographics, childhood risk factors (parental mental disorders, other childhood adversities) or comorbid DSM-IV disorders. However, FME manic episodes had greater clinical severity than non-FME episodes (assessed with a fully structured version of the Young Mania Rating Scale) and FME hypomanic episodes had greater role impairment than non-FME episodes (assessed with the Sheehan Disability Scales). Whether these indicators of severity merely reflect attenuated effects of rapid cycling or independent effects of sub-threshold rapid cycling warrants further study given the high proportion of lifetime cases who met criteria for FME.
- Subjects
BIPOLAR disorder; COMORBIDITY; EPIDEMIOLOGY; HYPOMANIA; AFFECTIVE disorders
- Publication
Molecular Psychiatry, 2010, Vol 15, Issue 11, p1075
- ISSN
1359-4184
- Publication type
Article
- DOI
10.1038/mp.2009.61