A prevalência global do transtorno bipolar é estimada em 2% a 2.5%.[19]Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011 Mar;68(3):241-51.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3486639
http://www.ncbi.nlm.nih.gov/pubmed/21383262?tool=bestpractice.com
[20]McGrath JJ, Al-Hamzawi A, Alonso J, et al. Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries. Lancet Psychiatry. 2023 Sep;10(9):668-81.
http://www.ncbi.nlm.nih.gov/pubmed/37531964?tool=bestpractice.com
Há taxas ligeiramente superiores do transtorno bipolar relatadas nos países desenvolvidos e de renda mais alta, o que pode refletir taxas mais altas de diagnóstico em vez de uma prevalência verdadeiramente mais alta.[21]Kessler RC, Kazdin AE, Aguilar-Gaxiola S, et al. Patterns and correlates of patient-reported helpfulness of treatment for common mental and substance use disorders in the WHO World Mental Health Surveys. World Psychiatry. 2022 Jun;21(2):272-86.
https://onlinelibrary.wiley.com/doi/10.1002/wps.20971
http://www.ncbi.nlm.nih.gov/pubmed/35524618?tool=bestpractice.com
A prevalência ao longo da vida do transtorno bipolar tipo I nos EUA é estimada entre 0.5% e 1.0%, afetando igualmente homens e mulheres.[22]Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the national comorbidity survey replication. Arch Gen Psychiatry. 2007 May;64(5):543-52. [Erratum in: Arch Gen Psychiatry. 2007 Sep;64(9):1039.]
http://archpsyc.jamanetwork.com/article.aspx?articleid=482285
http://www.ncbi.nlm.nih.gov/pubmed/17485606?tool=bestpractice.com
[23]Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018 Sep;8(9):251-69.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116765
http://www.ncbi.nlm.nih.gov/pubmed/30181867?tool=bestpractice.com
Estima-se que a prevalência do transtorno bipolar do tipo II ao longo da vida nos EUA esteja entre 0.5% e 1.1%; as mulheres têm maior probabilidade de serem afetadas que os homens.[19]Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011 Mar;68(3):241-51.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3486639
http://www.ncbi.nlm.nih.gov/pubmed/21383262?tool=bestpractice.com
[22]Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the national comorbidity survey replication. Arch Gen Psychiatry. 2007 May;64(5):543-52. [Erratum in: Arch Gen Psychiatry. 2007 Sep;64(9):1039.]
http://archpsyc.jamanetwork.com/article.aspx?articleid=482285
http://www.ncbi.nlm.nih.gov/pubmed/17485606?tool=bestpractice.com
Dados do Reino Unido sugerem uma prevalência do transtorno bipolar ao longo da vida de 1.7%.[24]Humpston CS, Bebbington P, Marwaha S. Bipolar disorder: prevalence, help-seeking and use of mental health care in England - findings from the 2014 adult psychiatric morbidity survey. J Affect Disord. 2021 Mar 1;282:426-33.
http://www.ncbi.nlm.nih.gov/pubmed/33422818?tool=bestpractice.com
De acordo com uma revisão sistemática, entre 1% e 4% de todos os pacientes atendidos na atenção primária satisfazem os critérios diagnósticos para transtorno bipolar.[25]Cerimele JM, Chwastiak LA, Dodson S, et al. The prevalence of bipolar disorder in general primary care samples: a systematic review. Gen Hosp Psychiatry. 2014 Jan-Feb;36(1):19-25.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877721
http://www.ncbi.nlm.nih.gov/pubmed/24144521?tool=bestpractice.com
Entre 21% e 54% das mulheres com depressão pós-parto têm transtorno bipolar.[26]Sharma V, Doobay M, Baczynski C. Bipolar postpartum depression: an update and recommendations. J Affect Disord. 2017 Sep;219:105-11.
http://www.ncbi.nlm.nih.gov/pubmed/28535448?tool=bestpractice.com
Uma pesquisa realizada com pacientes nos EUA constatou que 69% dos indivíduos diagnosticados com transtorno bipolar haviam sido erroneamente diagnosticados anteriormente, mais frequentemente com depressão unipolar.[27]Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003 Feb;64(2):161-74.
http://www.ncbi.nlm.nih.gov/pubmed/12633125?tool=bestpractice.com
Aproximadamente 35% dessas pessoas estiveram sintomáticas por >10 anos antes de serem diagnosticadas corretamente, sendo que as mulheres têm significativamente mais chances de serem diagnosticadas erroneamente que os homens.[27]Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003 Feb;64(2):161-74.
http://www.ncbi.nlm.nih.gov/pubmed/12633125?tool=bestpractice.com
Os dados que relatam atrasos no diagnóstico e no tratamento têm sido replicados.[28]Dagani J, Signorini G, Nielssen O, et al. Meta-analysis of the interval between the onset and management of bipolar disorder. Can J Psychiatry. 2017 Apr;62(4):247-58.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407546
http://www.ncbi.nlm.nih.gov/pubmed/27462036?tool=bestpractice.com
O National Institute for Health and Care Excellence do Reino Unido estima que a prevalência ao longo da vida de transtorno bipolar I seja de 1% na população adulta, enquanto o transtorno bipolar II parece afetar aproximadamente 0.4% dos adultos.[29]National Institute for Health and Care Excellence. Bipolar disorder: assessment and management. Dec 2023 [internet publication].
https://www.nice.org.uk/guidance/cg185
Os indivíduos com transtorno bipolar são sintomáticos por quase metade do tempo, com a sintomatologia depressiva predominando em sua experiência subjetiva.[30]Judd LL, Akiskal HS, Schettler PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002 Jun;59(6):530-7.
http://archpsyc.jamanetwork.com/article.aspx?articleid=206451
http://www.ncbi.nlm.nih.gov/pubmed/12044195?tool=bestpractice.com
Dados dos EUA relatam que estima-se que até 50% de todas as pessoas com transtorno bipolar realizam pelo menos uma tentativa de suicídio durante a vida, com 10% a 15% dos pacientes com transtorno bipolar não tratado morrendo por suicídio.[31]Goodwin FK, Jamison KR. Manic-depressive illness: bipolar disorders and recurrent depression. 2nd ed. New York, NY: Oxford University Press; 2007.[32]Dong M, Lu L, Zhang L, et al. Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies. Epidemiol Psychiatr Sci. 2019 Oct 25;29:e63.
https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/prevalence-of-suicide-attempts-in-bipolar-disorder-a-systematic-review-and-metaanalysis-of-observational-studies/494471CA6E53CECADA92AAF9246FDC5F
http://www.ncbi.nlm.nih.gov/pubmed/31648654?tool=bestpractice.com
[33]Miller JN, Black DW. Bipolar disorder and suicide: a review. Curr Psychiatry Rep. 2020 Jan 18;22(2):6.
http://www.ncbi.nlm.nih.gov/pubmed/31955273?tool=bestpractice.com
As taxas mais altas de probabilidade de suicídio ocorrem durante a fase de depressão aguda do transtorno bipolar, com a maioria das tentativas de suicídio ou mortes ocorrendo durante a fase depressiva.[34]Dome P, Rihmer Z, Gonda X. Suicide risk in bipolar disorder: a brief review. Medicina (Kaunas). 2019 Jul 24;55(8):403.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723289
http://www.ncbi.nlm.nih.gov/pubmed/31344941?tool=bestpractice.com
[35]Slama F, Bellivier F, Henry C, et al. Bipolar patients with suicidal behavior: toward the identification of a clinical subgroup. J Clin Psychiatry. 2004 Aug;65(8):1035-9.
http://www.ncbi.nlm.nih.gov/pubmed/15323586?tool=bestpractice.com
[36]Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018 Mar;20(2):97-170.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5947163
http://www.ncbi.nlm.nih.gov/pubmed/29536616?tool=bestpractice.com
Relatou-se que o transtorno de pânico eleva o risco de comportamento suicida e indica uma evolução mais grave.[8]Preti A, Vrublevska J, Veroniki AA, et al. Prevalence and treatment of panic disorder in bipolar disorder: systematic review and meta-analysis. Evid Based Ment Health. 2018 May;21(2):53-60.
http://www.ncbi.nlm.nih.gov/pubmed/29636354?tool=bestpractice.com
A maioria das pessoas com transtorno bipolar tem pelo menos uma comorbidade clínica que pode dificultar o diagnóstico e o tratamento. As comorbidades mais comuns incluem os transtornos por abuso de substâncias, transtornos de ansiedade, transtornos de pânico, transtornos de deficit da atenção, transtornos de personalidade e afecções clínicas comuns como obesidade, diabetes, hipertensão, enxaqueca e síndrome do intestino irritável.[7]McIntyre RS, Konarski JZ, Yatham LN. Comorbidity in bipolar disorder: a framework for rational treatment selection. Hum Psychopharmacol. 2004 Aug;19(6):369-86.
http://www.ncbi.nlm.nih.gov/pubmed/15303241?tool=bestpractice.com
[8]Preti A, Vrublevska J, Veroniki AA, et al. Prevalence and treatment of panic disorder in bipolar disorder: systematic review and meta-analysis. Evid Based Ment Health. 2018 May;21(2):53-60.
http://www.ncbi.nlm.nih.gov/pubmed/29636354?tool=bestpractice.com
[9]Compton WM, Thomas YF, Stinson FS, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2007 May;64(5):566-76.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482282
http://www.ncbi.nlm.nih.gov/pubmed/17485608?tool=bestpractice.com
[10]Preti A, Vrublevska J, Veroniki AA, et al. Prevalence, impact and treatment of generalised anxiety disorder in bipolar disorder: a systematic review and meta-analysis. Evid Based Ment Health. 2016 Aug;19(3):73-81.
https://ebmh.bmj.com/content/19/3/73.long
http://www.ncbi.nlm.nih.gov/pubmed/27405742?tool=bestpractice.com
[11]Grant BF, Stinson FS, Hasin DS, et al. Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2005 Oct;66(10):1205-15.
http://www.ncbi.nlm.nih.gov/pubmed/16259532?tool=bestpractice.com
[12]Ayerbe L, Forgnone I, Addo J, et al. Hypertension risk and clinical care in patients with bipolar disorder or schizophrenia; a systematic review and meta-analysis. J Affect Disord. 2018 Jan 1;225:665-70.
http://www.ncbi.nlm.nih.gov/pubmed/28915505?tool=bestpractice.com
[13]Fornaro M, Orsolini L, Marini S, et al. The prevalence and predictors of bipolar and borderline personality disorders comorbidity: Systematic review and meta-analysis. J Affect Disord. 2016 May;195:105-18.
http://www.ncbi.nlm.nih.gov/pubmed/26881339?tool=bestpractice.com
[14]Schiavone P, Dorz S, Conforti D, et al. Comorbidity of DSM-IV personality disorders in unipolar and bipolar affective disorders: a comparative study. Psychol Rep. 2004 Aug;95(1):121-8.
http://www.ncbi.nlm.nih.gov/pubmed/15460367?tool=bestpractice.com
[15]Mantere O, Melartin TK, Suominen K, et al. Differences in axis I and II comorbidity between bipolar I and II disorders and major depressive disorder. J Clin Psychiatry. 2006 Apr;67(4):584-93.
http://www.ncbi.nlm.nih.gov/pubmed/16669723?tool=bestpractice.com
[16]Salvi V, Ribuoli E, Servasi M, et al. ADHD and bipolar disorder in adulthood: clinical and treatment implications. Medicina (Kaunas). 2021 May 10;57(5):466.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151516
http://www.ncbi.nlm.nih.gov/pubmed/34068605?tool=bestpractice.com
Entre todos os transtornos de saúde mental graves, as pessoas com transtorno bipolar são as que têm algumas das taxas mais altas de comorbidade com transtornos por uso de substâncias.[11]Grant BF, Stinson FS, Hasin DS, et al. Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2005 Oct;66(10):1205-15.
http://www.ncbi.nlm.nih.gov/pubmed/16259532?tool=bestpractice.com
Nos EUA, a prevalência ao longo da vida de qualquer transtorno por uso de substâncias em pessoas com transtorno bipolar I é 5.1 vezes maior e, naquelas com transtorno bipolar II, é 2.4 vezes maior que nos indivíduos sem a doença.[9]Compton WM, Thomas YF, Stinson FS, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry. 2007 May;64(5):566-76.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482282
http://www.ncbi.nlm.nih.gov/pubmed/17485608?tool=bestpractice.com