Ji-Hyun Kim1, Sung Man Chang2, Jin Pyo Hong3, Jae Nam Bae1, Seong-Jin Cho4, Bong-Jin Hahm5, Dong-Woo Lee6, Jong-Ik Park7, Jun-Young Lee8, Hong Jin Jeon9, Byung-Soo Kim10, Maeng Je Cho11. 1. Department of Psychiatry, College of Medicine, Inha University, Incheon, South Korea. 2. Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea. Electronic address: psyjang@knu.ac.kr. 3. Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 4. Department of Psychiatry, Gachon Medical School, Gachon University of Medicine and Science, Incheon, South Korea. 5. Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, South Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea. 6. Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, South Korea. 7. Department of Psychiatry, College of Medicine, Kangwon National University, Chuncheon, South Korea. 8. Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, South Korea; Department of Neuropsychiatry, Seoul Metropolitan Boramae Medical Center, Seoul, South Korea. 9. Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Samsung Advanced Institute for Health Science & Technology (SAIHST), Seoul, South Korea. 10. Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, South Korea. 11. Department of Psychiatry and Behavioral Science, College of Medicine, Seoul National University, Seoul, South Korea.
Abstract
BACKGROUND: Patients with subthreshold bipolar disorder (Sub-BP) experience severe clinical courses and functional impairments which are comparable to those with bipolar I and II disorders (BP-I and -II). Nevertheless, lifetime prevalence, socioeconomic correlates and diagnostic overlaps of bipolar spectrum disorder (BPS) have not yet been estimated in the general population of South Korean adults. METHODS: A total of 3013 adults among the 2011 Korean Epidemiologic Catchment Area survey (KECA-2011) completed face-to-face interviews using the Korean versions of the Composite International Diagnostic Interview 2.1 and Mood Disorder Questionnaire (K-CIDI and K-MDQ). RESULTS: The lifetime prevalence of BPS in the South Korean adults was measured to be 4.3% (95% CI 2.6-6.9). Nearly 80% of the subjects with BPS were co-diagnosed with other DSM-IV non-psychotic mental disorders: 35.4% (95% CI 24.2-48.5) for major depression and dysthymic disorder, 35.1% (95% CI 27.7-43.3) for anxiety disorders, and 51.9% (95% CI 40.5-63.1) for alcohol and nicotine use disorders. Younger age (18-34 years) was the only sociodemographic predictor of BPS positivity (P=0.014), and the diagnostic overlap patterns were different between men and women. LIMITATIONS: The prevalence of BPS and other mental disorders could have been influenced by recall bias due to the retrospective nature of this study. CONCLUSIONS: Positivity for BPS was estimated to be much greater than the prevalence of DSM-IV BP in South Korea. Most of the respondents with BPS were diagnosed with other major mental disorders and this might be related with mis- and/or under-diagnosis of clinically relevant Sub-BP.
BACKGROUND:Patients with subthreshold bipolar disorder (Sub-BP) experience severe clinical courses and functional impairments which are comparable to those with bipolar I and II disorders (BP-I and -II). Nevertheless, lifetime prevalence, socioeconomic correlates and diagnostic overlaps of bipolar spectrum disorder (BPS) have not yet been estimated in the general population of South Korean adults. METHODS: A total of 3013 adults among the 2011 Korean Epidemiologic Catchment Area survey (KECA-2011) completed face-to-face interviews using the Korean versions of the Composite International Diagnostic Interview 2.1 and Mood Disorder Questionnaire (K-CIDI and K-MDQ). RESULTS: The lifetime prevalence of BPS in the South Korean adults was measured to be 4.3% (95% CI 2.6-6.9). Nearly 80% of the subjects with BPS were co-diagnosed with other DSM-IV non-psychotic mental disorders: 35.4% (95% CI 24.2-48.5) for major depression and dysthymic disorder, 35.1% (95% CI 27.7-43.3) for anxiety disorders, and 51.9% (95% CI 40.5-63.1) for alcohol and nicotine use disorders. Younger age (18-34 years) was the only sociodemographic predictor of BPS positivity (P=0.014), and the diagnostic overlap patterns were different between men and women. LIMITATIONS: The prevalence of BPS and other mental disorders could have been influenced by recall bias due to the retrospective nature of this study. CONCLUSIONS: Positivity for BPS was estimated to be much greater than the prevalence of DSM-IV BP in South Korea. Most of the respondents with BPS were diagnosed with other major mental disorders and this might be related with mis- and/or under-diagnosis of clinically relevant Sub-BP.