Stubbs Brendon, Vancampfort Davy, Solmi Marco, Veronese Nicola, Fornaro Michele
Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK Physiotherapy Department, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
UPC KU Leuven, Department of Neurosciences, KU Leuven, Kortenberg, Belgium Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Aust N Z J Psychiatry. 2016 Jul;50(7):631-9. doi: 10.1177/0004867415623857. Epub 2016 Jan 12.
There are mounting calls for bipolar disorder to be managed in primary care, yet the exact prevalence remains unclear. We conducted a meta-analysis to investigate the prevalence of bipolar disorder in general primary care attendees without other comorbid psychiatric diagnosis.
We systematically searched major electronic databases from inception till 03/2015. Articles were included that reported the prevalence of bipolar disorder determined in line with structured clinical assessment in primary care settings. Two independent authors conducted searches, completed methodological appraisal and extracted data. A random effects meta-analysis and meta-regression were performed.
Sixteen studies were included accounting for 425,691 participants (mean age = 41.1 years [standard deviation = 7.2 years] 33.3% males). Overall, the global prevalence of bipolar disorder was 1.9% (95% confidence interval = [0.6, 5.4]). The prevalence of bipolar disorder in studies recording a current diagnosis was 3.7% (95% confidence interval = [1.9, 6.0]) and 0.7% (95% confidence interval = [0.2, 1.5]) in studies considering a 12-month period. A diagnosis of bipolar disorder appeared higher in North America (3.7%, 95% confidence interval = [0.9, 8.1]) compared to Europe (0.8%, 95% confidence interval = [0.3, 1.5]). Meta-regression suggests that a more recent publication date (co-efficient = 0.089, 95% confidence interval = [0.0173, 0.1654], z = 2.19, p = 0.01, R(2) = 0.21) and younger age of participants (co-efficient -0.0851, 95% confidence interval = [-0.1696, 0.005], z = -1.97, p = 0.04, R(2) = 0.24) moderated a higher prevalence of bipolar disorder.
The global prevalence of bipolar disorder in primary care is 1.9%, with potentially higher prevalence rates in North America compared to Europe. A more recent study publication date is a significant predictor of higher prevalence of bipolar disorder. Potential reasons/drivers of this are considered within the text.
越来越多的人呼吁在初级保健中对双相情感障碍进行管理，但其确切患病率仍不清楚。我们进行了一项荟萃分析，以调查在没有其他合并精神疾病诊断的普通初级保健就诊者中双相情感障碍的患病率。
我们系统地检索了从开始到2015年3月的主要电子数据库。纳入的文章报告了在初级保健机构中根据结构化临床评估确定的双相情感障碍患病率。两名独立作者进行检索、完成方法学评估并提取数据。进行了随机效应荟萃分析和荟萃回归。
纳入了16项研究，涉及425,691名参与者（平均年龄 = 41.1岁[标准差 = 7.2岁]，男性占33.3%）。总体而言，双相情感障碍的全球患病率为1.9%（95%置信区间 = [0.6, 5.4]）。记录当前诊断的研究中双相情感障碍的患病率为3.7%（95%置信区间 = [1.9, 6.0]），而在考虑12个月期间的研究中为0.7%（95%置信区间 = [0.2, 1.5]）。与欧洲（0.8%，95%置信区间 = [0.3, 1.5]）相比，北美双相情感障碍的诊断率似乎更高（3.7%，95%置信区间 = [0.9, 8.1]）。荟萃回归表明，更近的发表日期（系数 = 0.089，95%置信区间 = [0.0173, 0.1654]，z = 2.19，p = 0.01，R(2)= 0.21）和参与者较年轻的年龄（系数 -0.0851，95%置信区间 = [-0.1696, 0.005]，z = -1.97，p = 0.04，R(2)= 0.24）导致双相情感障碍患病率较高。
初级保健中双相情感障碍的全球患病率为1.9%，与欧洲相比，北美患病率可能更高。更近的研究发表日期是双相情感障碍患病率较高的一个重要预测因素。本文中考虑了其潜在原因/驱动因素。
