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Under-reporting bipolar disorder in large-scale epidemiologic studies
Elie G Karam1, Nancy Sampson2, Lynn Itani3
1Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, Saint George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon.
Journal of Affective Disorders
|April 1, 2014
Summary
Epidemiologic studies may underestimate bipolar disorder prevalence. Inappropriately screened-out individuals showed higher rates of depression, earlier onset, and more suicide attempts, suggesting bipolar disorder is more common than reported.
Area of Science:
- Psychiatry
- Epidemiology
- Mental Health Research
Background:
- Clinical studies suggest epidemiologic research underestimates bipolar disorder prevalence.
- Investigating potential underestimation in large-scale surveys is crucial for accurate public health data.
Purpose of the Study:
- To determine if bipolar disorder prevalence is underestimated in epidemiologic studies.
- To compare characteristics of individuals screened out inappropriately (SCI) with those who continued (CONT) and a reference group (REF).
Main Methods:
- Analysis of World Mental Health Survey Initiative data from 47,552 participants across 8 countries.
- Identification of participants screened out inappropriately (SCI) from bipolar sections (euphoric and irritable).
- Comparison of SCI group characteristics with CONT and REF groups.
Main Results:
- The SCI group exhibited significantly higher rates of major depression, earlier age of onset, more suicide attempts, and more episodes compared to the REF group.
- Similar patterns were observed for both euphoric and irritable bipolar indicators.
- Higher comorbidity with anxiety, disruptive behavior disorders, and substance use was noted in the SCI group.
Conclusions:
- Findings suggest that a portion of individuals screened out inappropriately likely have bipolar disorder.
- The study supports the hypothesis that bipolar disorder is more prevalent than previously reported in epidemiologic research.
- Revision of current screening instruments in epidemiologic research is recommended to improve diagnostic accuracy.
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