Bipolar disorder with frequent mood episodes in the national comorbidity survey replication (NCS-R)
Open accessAbstract
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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Rapid cycling, or a course of illness that includes four or more mood episodes a year, affects up to one-third of patients with BDI.
“Rapid cycling, or a course of illness that includes four or more mood episodes a year, affects up to one‐third of patients with BDI.215, 216, 217, 218”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [216]
The Results (Prevalence, age-of-onset, and persistence; page unavailable) indicate that roughly one-third of respondents with lifetime bipolar I disorder had frequent mood episodes, defined as at least four episodes in 12 months. But the paper explicitly says this measure is a proxy and that the survey did not assess DSM-IV rapid cycling, so it does not establish that one-third had rapid cycling itself. (LLM, conf=0.88)
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Self-citation
- Authors
- Nierenberg, A. A., Akiskal, H. S., Angst, J., Hirschfeld, R. M., Merikangas, K. R., Petukhova, M., & Kessler, R. C.
- Affiliations
- Massachusetts General Hospital (US)
- University of California San Diego (US)
- University of Zurich (CH)
- The University of Texas Medical Branch at Galveston (US)
- National Institutes of Health (US)
- Harvard University (US)
- Corresponding author
- Kessler, R C
- Venue
- Molecular Psychiatry
- Published
- 2009-06-30
- Volume
- 15
- Issue
- 11
- Pages
- 1075-1087
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- PMC
- PMC2891194
- OpenAlex
- W2083320725
- Cited by
- 60
- References
- 45
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 23 · 2020: 3 · 2018: 1 · 2017: 1 · 2016: 4 · 2015: 1 · 2014: 4 · 2013: 4 · 2012: 3
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Molecular Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04)
- National Institute of Mental Health (R13-MH-066849, ZIAMH002806, Z01MH002806, U01-MH-60220, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (R01DA016558)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, rapid cycling, bipolar I disorder, bipolar II disorder, prevalence, age of onset, episode severity, hypomania, mania, comorbidities, role impairment, National Comorbidity Survey Replication
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Health Surveys, Humans, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, United States, Prevalence, Age of Onset, Self Report
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