Jules Angst1, Wulf Rössler1,2,3, Vladeta Ajdacic-Gross1, Felix Angst4, Hans Ulrich Wittchen5,6, Rosalind Lieb7,8, Katja Beesdo-Baum5,9, Eva Asselmann5,9, Kathleen R Merikangas10, Lihong Cui10, Laura H Andrade11, Maria C Viana12, Femke Lamers13, Brenda Wjh Penninx13, Taiane de Azevedo Cardoso14, Karen Jansen14, Luciano Dias de Mattos Souza14, Ricardo Azevedo da Silva14, Flavio Kapczinski15,16, Christoffel Grobler17,18, Mehdi Gholam-Rezaee19, Martin Preisig19, Caroline L Vandeleur19. 1. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland. 2. Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil. 3. Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany. 4. Rehabilitation Clinic, Bad Zurzach, Switzerland. 5. Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. 6. Psychiatric University Hospital, Ludwig-Maximilians-University, Munich, Germany. 7. Max Planck Institute of Psychiatry, Munich, Germany. 8. Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland. 9. Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. 10. Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland. 11. Section of Psychiatric Epidemiology (LIM 23), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, Brazil. 12. Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil. 13. Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands. 14. Health and Behavior Graduate Program, Catholic University of Pelotas, Pelotas, Brazil. 15. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 16. Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada. 17. Elizabeth Donkin Hospital, Port Elizabeth, South Africa. 18. Nelson Mandela University, Port Elizabeth, South Africa. 19. Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland.
Abstract
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.
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.
Authors: S Nassir Ghaemi; Jules Angst; Paul A Vohringer; Eric A Youngstrom; James Phelps; Philip B Mitchell; Roger S McIntyre; Michael Bauer; Eduard Vieta; Samuel Gershon Journal: Int J Bipolar Disord Date: 2022-10-13
Authors: Agnieszka Boroń; Małgorzata Śmiarowska; Anna Grzywacz; Krzysztof Chmielowiec; Jolanta Chmielowiec; Jolanta Masiak; Tomasz Pawłowski; Dariusz Larysz; Andrzej Ciechanowicz Journal: Int J Environ Res Public Health Date: 2022-08-12 Impact factor: 4.614
Authors: Ralph Kupka; Anne Duffy; Jan Scott; Jorge Almeida; Vicent Balanzá-Martínez; Boris Birmaher; David J Bond; Elisa Brietzke; Ines Chendo; Benicio N Frey; Iria Grande; Danella Hafeman; Tomas Hajek; Manon Hillegers; Marcia Kauer-Sant'Anna; Rodrigo B Mansur; Afra van der Markt; Robert Post; Mauricio Tohen; Hailey Tremain; Gustavo Vazquez; Eduard Vieta; Lakshmi N Yatham; Michael Berk; Martin Alda; Flávio Kapczinski Journal: Bipolar Disord Date: 2021-07-23 Impact factor: 5.345