Changes in the prevalence of bipolar disorders between 1998 and 2008 in an Australian population

Royal Adelaide Hospital Discipline of Psychiatry, University of Adelaide, Australia.
Bipolar Disorders (Impact Factor: 4.97). 03/2011; 13(2):182-8. DOI: 10.1111/j.1399-5618.2011.00907.x
Source: PubMed


To identify any changes in the prevalence of bipolar disorder (BD) between 1998, 2004, and 2008.
Cross-sectional population-based surveys were conducted involving random and representative samples of South Australian adults aged ≥ 15 years. BD was assessed using the mood module of the Primary Care Evaluation of Mental Disorders instrument (PRIME-MD), a single question related to doctor-diagnosed BD and the Mood Disorder Questionnaire (MDQ), which defines bipolar spectrum disorder.
  The PRIME-MD-derived prevalence of BD increased significantly from 0.5% [95% confidence interval (CI): 0.27-0.79] in 1998 to 1.0% (95% CI: 0.61-1.31) in 2004 and 1.5% (95% CI: 1.05-1.91) in 2008, demonstrating a significant increased linear trend (χ² =13.91, df=2, p=0.002). Similarly, reported doctor-diagnosed BD increased significantly from 1.1% (95% CI: 0.75-1.51) in 1998 to 1.7% (95% CI: 1.26-2.18) in 2004 and 2.9% (95% CI: 2.28-3.48) in 2008 (Linear trend test χ²=24.55, df=2, p<0.001). The MDQ-derived diagnosis of bipolar spectrum disorder changed from 2.5% (95% CI: 1.96-3.08) in 2004 to 3.3% (95% CI: 2.66-3.94) in 2008 (χ² =3.22, df=1, p<0.10), but this difference did not attain statistical significance. Confining the analysis to those positive for BD on all three methods, there was a significant increase in the prevalence of the detection of BD using all three measures (χ² =4.43, df=1, p=0.03) between 2004 and 2008.
There has been an increased prevalence of BD in South Australia over the last decade, but this may be related to changing diagnostic practices rather than a true increase.

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    • "The lifetime prevalence of BD I (manic, mixed or depressed) and BD II (hypomanic, depressed) is estimated as 2.1%; of the US population, however, if one considers sub-threshold cases, the lifetime prevalence may be as high as 4.5%; [2]. Similar figures were reported by a recent Australian-based study in which the prevalence of BD was estimated between 2.5%; and 2.9%; [3,4]. "
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