Bipolar affective disorder in India: A multi-site population-based cross-sectional study

Area of Science:

• Psychiatry
• Epidemiology
• Public Health

Background:

• Bipolar Affective Disorder (BPAD) presents a significant public health challenge due to its high disability burden, prevalence of comorbidities, risk of suicidality, and treatment gap.
• Understanding the epidemiological profile of BPAD in India is crucial for targeted interventions.

Purpose of the Study:

• To determine the lifetime and current prevalence of BPAD in the adult Indian population.
• To identify correlates, comorbidities, associated disabilities, and the treatment gap for BPAD.

Main Methods:

• The study utilized data from the National Mental Health Survey (NMHS) 2016, a nationally representative survey of 34,802 adults across 12 Indian states.
• BPAD diagnosis was established using the Mini-International Neuropsychiatric Interview (MINI) 6.0.0, and disability was assessed using Sheehan's Disability Scale.

Main Results:

• The weighted prevalence of current BPAD was 0.3% and lifetime prevalence was 0.5%.
• Male gender and urban metropolitan residence were associated with a higher risk of lifetime BPAD.
• Significant comorbidities included tobacco use disorder (33.3%), other substance use disorders (14.6%), and anxiety disorders (10.4%).
• Two-thirds of individuals with current BPAD reported moderate to severe disability in work, social, and family life.
• A substantial treatment gap of 70.4% was observed for current BPAD cases.

Conclusions:

• BPAD is associated with considerable disability and high rates of comorbidities in the Indian adult population.
• The significant treatment gap highlights the urgent need for improved access to care and policy interventions.
• Addressing BPAD requires focused strategies from policymakers to mitigate its impact on individuals and society.