Fajutrao Liberty, Locklear Julie, Priaulx Jennifer, Heyes Anne
Health Economics and Outcomes, AstraZeneca R&D, Södertälje, Sweden.
Clin Pract Epidemiol Ment Health. 2009 Jan 23;5:3. doi: 10.1186/1745-0179-5-3.
Bipolar disorder is recognized as a major mental health issue, and its economic impact has been examined in the United States. However, there exists a general scarcity of published studies and lack of standardized data on the burden of the illness across European countries. In this systematic literature review, we highlight the epidemiological, clinical, and economic outcomes of bipolar disorder in Europe.
A systematic review of publications from the last 10 years relating to the burden of bipolar disorder was conducted, including studies on epidemiology, patient-related issues, and costs.
Data from the UK, Germany, and Italy indicated a prevalence of bipolar disorder of ~1%, and a misdiagnosis rate of 70% from Spain. In one study, up to 75% of patients had at least one DSM-IV comorbidity, commonly anxiety disorders and substance/alcohol abuse. Attempted suicide rates varied between 21%-54%. In the UK, the estimated rate of premature mortality of patients with bipolar I disorder was 18%. The chronicity of bipolar disorder exerted a profound and debilitating effect on the patient. In Germany, 70% of patients were underemployed, and 72% received disability payments. In Italy, 63%-67% of patients were unemployed. In the UK, the annual costs of unemployment and suicide were pound1510 million and pound179 million, respectively, at 1999/2000 prices. The estimated UK national cost of bipolar disorder was pound4.59 billion, with hospitalization during acute episodes representing the largest component.
Bipolar disorder is a major and underestimated health problem in Europe. A number of issues impact on the economic burden of the disease, such as comorbidities, suicide, early death, unemployment or underemployment. Direct costs of bipolar disorder are mainly associated with hospitalization during acute episodes. Indirect costs are a major contributor to the overall economic burden but are not always recognized in research studies.
双相情感障碍被认为是一个主要的心理健康问题，其在美国的经济影响已得到研究。然而，欧洲各国关于该疾病负担的已发表研究普遍匮乏，且缺乏标准化数据。在这项系统文献综述中，我们着重介绍了欧洲双相情感障碍的流行病学、临床和经济结果。
对过去10年中有关双相情感障碍负担的出版物进行系统综述，包括流行病学、患者相关问题和成本方面的研究。
来自英国、德国和意大利的数据表明双相情感障碍的患病率约为1%，西班牙的误诊率为70%。在一项研究中，高达75%的患者至少有一种DSM-IV共病，常见的是焦虑症和物质/酒精滥用。自杀未遂率在21%至54%之间。在英国，双相I型障碍患者的过早死亡率估计为18%。双相情感障碍的慢性病程对患者产生了深远且使人衰弱的影响。在德国，70%的患者就业不足，72%的患者领取残疾津贴。在意大利，63%至67% 的患者失业。以1999/2000年的价格计算，在英国，失业和自杀的年度成本分别为15.1亿英镑和1.79亿英镑。英国双相情感障碍的估计全国成本为45.9亿英镑，急性发作期间的住院费用占最大部分。
双相情感障碍在欧洲是一个主要且被低估的健康问题。一些问题影响着该疾病的经济负担，如共病、自杀、过早死亡、失业或就业不足。双相情感障碍的直接成本主要与急性发作期间的住院治疗有关。间接成本是总体经济负担的主要贡献因素，但在研究中并不总是得到认可。
