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Developing a Rat Model for Bipolar Disorder
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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
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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.

Keywords:
Bipolar disorderComposite International Diagnostic InterviewDiagnosis

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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.