Differences between unipolar mania and bipolar-I disorder: Evidence from nine epidemiological studies.

Journal: Bipolar disorders

Volume: 21

Issue: 5

Year of Publication: 2020

Affiliated Institutions:  Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland. Rehabilitation Clinic, Bad Zurzach, Switzerland. Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. Max Planck Institute of Psychiatry, Munich, Germany. Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland. Section of Psychiatric Epidemiology (LIM ), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, Brazil. Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil. Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands. Health and Behavior Graduate Program, Catholic University of Pelotas, Pelotas, Brazil. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Elizabeth Donkin Hospital, Port Elizabeth, South Africa. Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland.

Abstract summary 

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.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.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.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 & Co-authors:  Angst Jules J Rössler Wulf W Ajdacic-Gross Vladeta V Angst Felix F Wittchen Hans Ulrich HU Lieb Rosalind R Beesdo-Baum Katja K Asselmann Eva E Merikangas Kathleen R KR Cui Lihong L Andrade Laura H LH Viana Maria C MC Lamers Femke F Penninx Brenda Wjh BW de Azevedo Cardoso Taiane T Jansen Karen K Dias de Mattos Souza Luciano L Azevedo da Silva Ricardo R Kapczinski Flavio F Grobler Christoffel C Gholam-Rezaee Mehdi M Preisig Martin M Vandeleur Caroline L CL

Study Outcome 

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Statistics
Citations : 
Authors :  23
Identifiers
Doi : 10.1111/bdi.12732
SSN : 1399-5618
Study Population
Male
Mesh Terms
Adolescent
Other Terms
bipolar-I disorder;comorbidity;epidemiology;family history;gender;mania
Study Design
Cross Sectional Study
Study Approach
Mixed Methods
Country of Study
Publication Country
Denmark