Journal
BIPOLAR DISORDERS
Volume 21, Issue 5, Pages 437-448Publisher
WILEY
DOI: 10.1111/bdi.12732
Keywords
bipolar-I disorder; comorbidity; epidemiology; family history; gender; mania
Categories
Funding
- ZonMw [10-000-1002]
- Fogarty International Center [FIRCA R03-TW006481]
- National Institute of Mental Health [R01MH070884, U01-MH60220]
- Pfizer Foundation
- Robert Wood Johnson Foundation [004708, 044780]
- Fundacao de Amparo a Pesquisa do Estado de Sao Paulo [2003/00204-3, 2011/50517-4]
- Schweizerischer Nationalfonds zur Forderung der Wissenschaftlichen Forschung [32-50881.97, 3200-050881.97/1, 3200B0-105993, 3200B0-188308, 3247B0-122071, 33CS30-139468, 33CS30-148401, 33CSCO-122661]
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [465458/2014-9, 573671/2008-7]
- US Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Deutsche Forschungsgemeinschaft [LA1148/1-1, WI2246/1-1, WI709/7-1, WI709/8-1]
- Bundesministerium fur Bildung und Forschung [01EB0140, 01EB0440, 01EB9405/6, 01EB9901/6, 01ER1303, 01ER1703, EB01016200]
- Ortho-McNeil Pharmaceutical, Inc.
- Pan American Health Organization
- Eli Lilly and Company
- John D. and Catherine T. MacArthur Foundation
- GGZ inGeest
- GGZ Friesland
- GGZ Drenthe
- Vrije Universiteit Amsterdam
- GGZ Rivierduinen
- Leids Universitair Medisch Centrum
- GlaxoSmithKline
- Fundo de Apoio a Ciencia e Tecnologia do Municipio de Vitoria [002/2003]
- University of Groningen
- John W. Alden Trust
- Substance Abuse and Mental Health Services Administration
- University Medical Centre Groningen
- Lentis A
- GlaxoSmithKline Foundation
- National Institute of Drug Abuse [R01DA016558]
- Faculty of Biology and Medicine of the Lausanne University
- Rob Giel Onderzoekscentrum
- NATIONAL INSTITUTE OF MENTAL HEALTH [ZIAMH002953] Funding Source: NIH RePORTER
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Objectives Although clinical evidence suggests important differences between unipolar mania and bipolar-I disorder (BP-I), epidemiological data are limited. Combining data from nine population-based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP-I with both manic and depressive episodes with respect to demographic and clinical characteristics in order to highlight differences. Methods Participants were compared for gender, age, age at onset of mania, psychiatric comorbidity, temperament, and family history of mental disorders. Generalized linear mixed models with adjustment for sex and age as well as for each study source were applied. Analyses were performed for the pooled adult and adolescent samples, separately. Results Within the included cohorts, 109 adults and 195 adolescents were diagnosed with M/Md and 323 adults and 182 adolescents with BP-I. In both adult and adolescent samples, there was a male preponderance in M/Md, whereas lifetime generalized anxiety and/panic disorders and suicide attempts were less common in M/Md than in BP-I. Furthermore, adults with mania revealed bulimia/binge eating and drug use disorders less frequently than those with BP-I. Conclusions The significant differences found in gender and comorbidity between mania and BP-I suggest that unipolar mania, despite its low prevalence, should be established as a separate diagnosis both for clinical and research purposes. In clinical settings, the rarer occurrence of suicide attempts, anxiety, and drug use disorders among individuals with unipolar mania may facilitate successful treatment of the disorder and lead to a more favorable course than that of BP-I disorder.
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