Clemente Adauto S, Diniz Breno S, Nicolato Rodrigo, Kapczinski Flavio P, Soares Jair C, Firmo Josélia O, Castro-Costa Érico
Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.
Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Braz J Psychiatry. 2015 Apr-Jun;37(2):155-61. doi: 10.1590/1516-4446-2012-1693. Epub 2015 May 1.
Bipolar disorder (BD) is common in clinical psychiatric practice, and several studies have estimated its prevalence to range from 0.5 to 5% in community-based samples. However, no systematic review and meta-analysis of the prevalence of BD type 1 and type 2 has been published in the literature. We carried out a systematic review and meta-analysis of the lifetime and 1-year prevalence of BD type 1 and type 2 and assessed whether the prevalence of BD changed according to the diagnostic criteria adopted (DSM-III, DSM-III-R vs. DSM-IV).
We searched MEDLINE, Scopus, Web of Science, PsycINFO, and the reference lists of identified studies. The analyses included 25 population- or community-based studies and 276,221 participants.
The pooled lifetime prevalence of BD type 1 was 1.06% (95% confidence interval [95%CI] 0.81-1.31) and that of BD type 2 was 1.57% (95%CI 1.15-1.99). The pooled 1-year prevalence was 0.71% (95%CI 0.56-0.86) for BD type 1 and 0.50% (95%CI 0.35-0.64) for BD type 2. Subgroup analysis showed a significantly higher lifetime prevalence of BD type 1 according to the DSM-IV criteria compared to the DSM-III and DSM-IIIR criteria (p < 0.001).
This meta-analysis confirms that estimates of BD type 1 and type 2 prevalence are low in the general population. The increase in prevalence from DSM-III and DSM-III-R to DSM-IV may reflect different factors, such as minor changes in diagnostic operationalization, use of different assessment instruments, or even a genuine increase in the prevalence of BD.
双相情感障碍（BD）在临床精神科实践中很常见，多项研究估计其在社区样本中的患病率为0.5%至5%。然而，文献中尚未发表关于1型和2型双相情感障碍患病率的系统评价和荟萃分析。我们对1型和2型双相情感障碍的终生患病率和1年患病率进行了系统评价和荟萃分析，并评估了双相情感障碍的患病率是否根据所采用的诊断标准（DSM-III、DSM-III-R与DSM-IV）而有所变化。
我们检索了MEDLINE、Scopus、科学引文索引、PsycINFO以及已识别研究的参考文献列表。分析纳入了25项基于人群或社区的研究以及276,221名参与者。
1型双相情感障碍的合并终生患病率为1.06%（95%置信区间[95%CI]0.81-1.31），2型双相情感障碍的合并终生患病率为1.57%（95%CI 1.15-1.99）。1型双相情感障碍的合并1年患病率为0.71%（95%CI 0.56-0.86），2型双相情感障碍的合并1年患病率为0.50%（95%CI 0.35-0.64）。亚组分析显示，与DSM-III和DSM-IIIR标准相比，根据DSM-IV标准，1型双相情感障碍的终生患病率显著更高（p<0.001）。
这项荟萃分析证实，1型和2型双相情感障碍在普通人群中的患病率估计较低。从DSM-III和DSM-III-R到DSM-IV患病率的增加可能反映了不同因素，如诊断操作的微小变化、使用不同的评估工具，甚至双相情感障碍患病率的真正增加。
