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Differences between unipolar mania and bipolar‐I disorder: Evidence from nine epidemiological studies
Author(s) -
Angst Jules,
Rössler Wulf,
AjdacicGross Vladeta,
Angst Felix,
Wittchen Hans Ulrich,
Lieb Rosalind,
BeesdoBaum Katja,
Asselmann Eva,
Merikangas Kathleen R,
Cui Lihong,
Andrade Laura H,
Viana Maria C,
Lamers Femke,
Penninx Brenda WJH,
Azevedo Cardoso Taiane,
Jansen Karen,
Dias de Mattos Souza Luciano,
Azevedo da Silva Ricardo,
Kapczinski Flavio,
Grobler Christoffel,
GholamRezaee Mehdi,
Preisig Martin,
Vandeleur Caroline L
Publication year - 2019
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12732
Subject(s) - mania , bipolar disorder , psychiatry , anxiety , comorbidity , psychology , clinical psychology , panic disorder , depression (economics) , age of onset , epidemiology , hypomania , medicine , mood , disease , economics , macroeconomics
Objectives Although clinical evidence suggests important differences between unipolar mania and bipolar‐I disorder (BP‐I), epidemiological data are limited. Combining data from nine population‐based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP‐I with both manic and depressive episodes with respect to demographic and clinical characteristics in order to highlight differences. Methods Participants were compared for gender, age, age at onset of mania, psychiatric comorbidity, temperament, and family history of mental disorders. Generalized linear mixed models with adjustment for sex and age as well as for each study source were applied. Analyses were performed for the pooled adult and adolescent samples, separately. Results Within the included cohorts, 109 adults and 195 adolescents were diagnosed with M/Md and 323 adults and 182 adolescents with BP‐I. In both adult and adolescent samples, there was a male preponderance in M/Md, whereas lifetime generalized anxiety and/panic disorders and suicide attempts were less common in M/Md than in BP‐I. Furthermore, adults with mania revealed bulimia/binge eating and drug use disorders less frequently than those with BP‐I. Conclusions The significant differences found in gender and comorbidity between mania and BP‐I suggest that unipolar mania, despite its low prevalence, should be established as a separate diagnosis both for clinical and research purposes. In clinical settings, the rarer occurrence of suicide attempts, anxiety, and drug use disorders among individuals with unipolar mania may facilitate successful treatment of the disorder and lead to a more favorable course than that of BP‐I disorder.