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Text Box: Over 4 Percent Of US Adults Have Some Form Of Bipolar Disorder
Source: Psychnotes, May 12, 2007, http://psychnotes.techpsych.net/ Posted by: rsk @ 11:36 pm
Editorial comments will be placed in brackets to explain why we thought this article was significant. Some of the findings may seem self-evident, while others are new to us, and may be to you as well. Researchers from the National Institute of Mental Health [major organization], estimated the national prevalence of bipolar disorder using data from 9,282 individuals [this sample is larger than what you are likely to find in most studies] chosen to represent the general population. They conducted interviews between February 2001 and April 2003 to assess the presence of bipolar disorder and other psychiatric conditions. Participants were classified as having bipolar disorder I, characterized by at least one episode of mania and one of depression; bipolar disorder II, requiring an episode of depression plus hypomania, a milder form of mania that does not require hospitalization; and a milder, sub-threshold bipolar disorder that involves hypomania with or without depression, otherwise classified as bipolar disorder “not otherwise specified” in the current diagnostic nomenclature of the American Psychiatric Association. [This category is new to me, and suggests that psychiatrists are beginning to recognize that this condition is more complex than previously believed.]
Results of the survey show that approximately 4.4 percent of U.S. adults may have some form of bipolar disorder during some point in their lifetime, including about 2.4 percent with a “sub-threshold” condition. [Please note that this statistic is higher than earlier estimates. But bipolar disorder is underdiagnosed because one of its classic symptoms is denial.]
The study found that:
* A total of 1.0 percent of participants had bipolar disorder I and 1.1 percent had bipolar disorder II in their lifetimes; in the previous 12 months, 0.6 percent had bipolar disorder I, 0.8 percent bipolar disorder II and 1.4 percent sub-threshold manifestations of bipolar disorder.
* Symptoms began at age 18.2 years for bipolar disorder I, 20.3 years for bipolar disorder II and 22.2 years for sub-

Text Box: * 95.8 to 97.7 percent of those with bipolar disorder and 88.4 percent of those with sub-threshold bipolar disorder also had another psychiatric condition, such as an anxiety disorder or substance use disorder, which is a frequent complication of bipolar illness. [This estimate of comorbidity is much higher than what we have encountered in the literature.]
* The majority of those with lifetime bipolar disorder (80.1 percent) received treatment, including 69.3 percent of those with sub-threshold bipolar disorder; most of those people sought treatment for the depression rather than for the manic symptoms of bipolar disorder.
* However, over the previous 12 months, only 25 percent of those with bipolar disorder I, 15.4 percent with bipolar disorder II and 8.1 percent with sub-threshold bipolar disorder received appropriate medication
These results are reported in this month’s Archives of General Psychiatry and the authors point out that the present results reinforce the argument of other researchers that clinically significant sub-threshold bipolar disorder is at least as common as threshold bipolar disorder., They also note that “although most individuals with bipolar disorder receive treatment owing to co-morbid disorders, the lack of recognition of their underlying bipolarity leads to only a few receiving appropriate treatment.” [This is particularly true of the dually diagnosed; for them it is not enough to address substance abuse or bipolar disorder—both problems have to be dealt with.] The findings suggest that a substantial proportion of those diagnosed with major depression may actually have a form of bipolar disorder. [Perhaps this insight explains why so many individuals classified as depressives do not respond to the standard treatments for unipolar depression.] The researchers conclude that more individuals with other psychiatric disorders should also be screened for bipolar disorder and that additional research is needed to resolve uncertainty regarding the most appropriate threshold and boundary distinctions for bipolar disorder. This uncertainty remains a major impediment to advancing the understanding

Text Box: "Never be bullied into silence.
Never allow yourself to be made a victim. Accept no one's definition of your life; define yourself."
Harvey Fierstein