Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R)

A. A. Nierenberg, H. S. Akiskal, J. Angst, R. M. Hirschfeld, K. R. Merikangas, M. Petukhova, R. C. Kessler

Research output: Contribution to journalArticle

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Abstract

Virtually nothing is known about the epidemiology of rapid cycling bipolar disorder (BPD) in community samples. Nationally representative data are reported here for the prevalence and correlates of a surrogate measure of DSM-IV rapid cycling BPD from the National Comorbidity survey Replication (NCS-R), a national survey of the US household population. DSM-IV disorders were assessed in the NCS-R with the WHO Composite International Diagnostic Interview (CIDI). Although the CIDI did not assess rapid cycling, it did assess the broader category of 12-month BPD with frequent mood episodes (FMEs), having at least four episodes of mania/hypomania or major depression in the 12 months before interview. Roughly one-third of NCS-R respondents with lifetime DSM-IV BPD and half with 12-month BPD met criteria for FME. FME was associated with younger age-of-onset (of BP-I, but not BP-II) and higher annual persistence (73% of the years since first onset of illness with an episode) than non-FME BPD. No substantial associations of FME vs non-FME BPD were found with socio-demographics, childhood risk factors (parental mental disorders, other childhood adversities) or comorbid DSM-IV disorders. However, FME manic episodes had greater clinical severity than non-FME episodes (assessed with a fully structured version of the Young Mania Rating Scale) and FME hypomanic episodes had greater role impairment than non-FME episodes (assessed with the Sheehan Disability Scales). Whether these indicators of severity merely reflect attenuated effects of rapid cycling or independent effects of sub-threshold rapid cycling warrants further study given the high proportion of lifetime cases who met criteria for FME.

Original languageEnglish (US)
Pages (from-to)1075-1087
Number of pages13
JournalMolecular Psychiatry
Volume15
Issue number11
DOIs
StatePublished - Nov 2010

Fingerprint

Bipolar Disorder
Comorbidity
Diagnostic and Statistical Manual of Mental Disorders
Interviews
Surveys and Questionnaires
Age of Onset
Mental Disorders
Epidemiology
Demography
Depression

Keywords

  • bipolar disorder
  • comorbidity
  • hypomania
  • mania
  • national comorbidity survey replication (NCS-R)
  • rapid-cycling bipolar disorder
  • treatment

ASJC Scopus subject areas

  • Molecular Biology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience

Cite this

Nierenberg, A. A., Akiskal, H. S., Angst, J., Hirschfeld, R. M., Merikangas, K. R., Petukhova, M., & Kessler, R. C. (2010). Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R). Molecular Psychiatry, 15(11), 1075-1087. https://doi.org/10.1038/mp.2009.61

Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R). / Nierenberg, A. A.; Akiskal, H. S.; Angst, J.; Hirschfeld, R. M.; Merikangas, K. R.; Petukhova, M.; Kessler, R. C.

In: Molecular Psychiatry, Vol. 15, No. 11, 11.2010, p. 1075-1087.

Research output: Contribution to journalArticle

Nierenberg, AA, Akiskal, HS, Angst, J, Hirschfeld, RM, Merikangas, KR, Petukhova, M & Kessler, RC 2010, 'Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R)', Molecular Psychiatry, vol. 15, no. 11, pp. 1075-1087. https://doi.org/10.1038/mp.2009.61
Nierenberg AA, Akiskal HS, Angst J, Hirschfeld RM, Merikangas KR, Petukhova M et al. Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R). Molecular Psychiatry. 2010 Nov;15(11):1075-1087. https://doi.org/10.1038/mp.2009.61
Nierenberg, A. A. ; Akiskal, H. S. ; Angst, J. ; Hirschfeld, R. M. ; Merikangas, K. R. ; Petukhova, M. ; Kessler, R. C. / Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R). In: Molecular Psychiatry. 2010 ; Vol. 15, No. 11. pp. 1075-1087.
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abstract = "Virtually nothing is known about the epidemiology of rapid cycling bipolar disorder (BPD) in community samples. Nationally representative data are reported here for the prevalence and correlates of a surrogate measure of DSM-IV rapid cycling BPD from the National Comorbidity survey Replication (NCS-R), a national survey of the US household population. DSM-IV disorders were assessed in the NCS-R with the WHO Composite International Diagnostic Interview (CIDI). Although the CIDI did not assess rapid cycling, it did assess the broader category of 12-month BPD with frequent mood episodes (FMEs), having at least four episodes of mania/hypomania or major depression in the 12 months before interview. Roughly one-third of NCS-R respondents with lifetime DSM-IV BPD and half with 12-month BPD met criteria for FME. FME was associated with younger age-of-onset (of BP-I, but not BP-II) and higher annual persistence (73{\%} of the years since first onset of illness with an episode) than non-FME BPD. No substantial associations of FME vs non-FME BPD were found with socio-demographics, childhood risk factors (parental mental disorders, other childhood adversities) or comorbid DSM-IV disorders. However, FME manic episodes had greater clinical severity than non-FME episodes (assessed with a fully structured version of the Young Mania Rating Scale) and FME hypomanic episodes had greater role impairment than non-FME episodes (assessed with the Sheehan Disability Scales). Whether these indicators of severity merely reflect attenuated effects of rapid cycling or independent effects of sub-threshold rapid cycling warrants further study given the high proportion of lifetime cases who met criteria for FME.",
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