Epidemiology

Global prevalence of bipolar disorder is estimated at 2% to 2.5%.[19][20]​​ There are slightly higher rates of bipolar disorder reported in higher-income, developed countries, which may reflect higher rates of diagnosis rather than true higher prevalence.[21]

The lifetime prevalence of bipolar disorder type I in the US is estimated to be between 0.5% and 1.0%, affecting men and women equally.[22][23]​​​ The lifetime prevalence of bipolar disorder type II in the US is estimated to be between 0.5% and 1.1%, with women more likely than men to be affected.[19][22]​​​​​ Data from the UK suggest a bipolar disorder lifetime prevalence of 1.7%.​[24]​​ Between 1% and 4% of all patients attending a primary care setting meet the diagnostic criteria for bipolar disorder according to one systematic review.[25] Between 21% and 54% of women with postnatal depression have bipolar disorder.[26]

One US patient survey found that 69% of individuals diagnosed with bipolar disorder had been previously misdiagnosed, most frequently with unipolar depression.[27] About 35% of these people were symptomatic for >10 years before being accurately diagnosed, with women significantly more likely than men to be misdiagnosed.[27] Data reporting delays to diagnosis and management have been replicated.[28]

The UK National Institute for Health and Care Excellence estimates the lifetime prevalence of bipolar I disorder at 1% of the adult population, while bipolar II disorder is believed to affect approximately 0.4% of adults.[29]

People with bipolar disorder are symptomatic for nearly half of the time, with depressive symptomatology predominating in their subjective experience.[30]

US data report that up to 50% of all people with bipolar disorder have been estimated to make at least one suicide attempt in their lifetime, with 10% to 15% of untreated patients with bipolar disorder dying by suicide.[31][32][33]​​​

The highest rates of suicidality occur during the acutely depressed phase of bipolar disorder, with the majority of the suicidal attempts or deaths occuring during the depressive phase.[34][35][36]​​ Comorbid panic disorder has been reported to increase the risk of suicidal behaviour and indicate a more severe course.[8]

Most people with bipolar disorder have at least one comorbid condition that may complicate diagnosis and treatment. The most common comorbidities include substance use disorders, anxiety disorders, panic disorders, attention-deficit disorders, personality disorders, and common medical conditions such as obesity, diabetes, hypertension, migraine, and irritable bowel syndrome.[7][8][9][10][11][12][13][14][15][16] Among all serious mental health disorders, people with bipolar disorder are known to have some of the highest rates of comorbid substance use disorders.[11] In the US, the lifetime prevalence of any substance use disorder in people with bipolar I disorder is 5.1 times and in those with bipolar II disorder is 2.4 times higher than in those without the condition.[9]

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