Bebbington P, Ramana R
MRC Social & Community Psychiatry Unit, Institute of Psychiatry, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 1995 Nov;30(6):279-92. doi: 10.1007/BF00805795.
This paper reviews the current position of studies on the epidemiology of bipolar affective disorder. A disorder that cannot be recognized until sometime after its onset poses special difficulties for epidemiological study. These are discussed and attempts made to solve them. Community psychiatric surveys suggest a morbid risk of bipolar disorder of around 2-2.5%, but probably include many false-positives. Studies of treated cases indicate a morbid risk of 0.5%, but will miss untreated cases. It is probably reasonable to suggest a compromise value of 1-1.5%; bipolar disorder is thus still a rare condition. It is possible to quantify the unipolar-bipolar conversion rate, which is of the order of 5%, and is of particular interest that female sufferers have proportionately fewer manic episodes. Age at onset, possible cohort phenomena, comorbidity, and sociodemographic correlates are discussed.
本文综述了双相情感障碍流行病学研究的现状。一种在发病一段时间后才能被识别的疾病给流行病学研究带来了特殊困难。文中对这些困难进行了讨论并尝试加以解决。社区精神病学调查显示双相情感障碍的患病风险约为2% - 2.5%，但可能包含许多假阳性病例。对已接受治疗病例的研究表明患病风险为0.5%，但会遗漏未接受治疗的病例。提出1% - 1.5%的折衷值可能是合理的；因此双相情感障碍仍然是一种罕见疾病。单极 - 双极转换率可以量化，约为5%，特别值得注意的是女性患者的躁狂发作比例相对较少。文中还讨论了发病年龄、可能的队列现象、共病情况以及社会人口统计学相关因素。
