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

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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 1 2010

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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