Bipolar disorder, also known as bipolar depression or manic depression, is a psychological disorder that presents with severe shifts in mood from one extreme to another. The mood swings occur in a cyclic or periodic pattern that includes feelings of emotional highs (mania or hypomania) and lows (depression). The bipolar spectrum of diseases places a significant burden on individuals and their families; in addition, people with bipolar disorder suffer from delayed diagnosis and treatment, which is related to an increase in lifetime suicide attempts and anxiety disorders, increasing the importance of improving the early diagnosis of bipolar disorder.
According to last month’s study by Keramatian and colleagues published in the Journal of Affective Disorders, there was an average delay of eight years between the onset and diagnosis of bipolar disorder in Canada. In this multicentre study, 319 patients with the difference between the time at first mood episode and the correct diagnosis were recorded. It was observed that the difference between symptom and diagnosis ranged from five to 11 years. The long delay, as the study suggests, would add to the burden of this condition.
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The lifetime total prevalence of the bipolar spectrum of diseases ranges from 0.6% in Japan to more than 4.5% in the US and is expected to rise steadily in the future. GlobalData epidemiologists forecast that the total lifetime prevalent cases of bipolar disorder in the eight major markets (8MM, namely the US, France, Germany, Italy, Spain, the UK, Japan and Canada) will grow at an annual growth rate (AGR) of 0.5% a year over the next ten years, from 22.99 million cases last year to 24.23 million cases in 2030 (as shown in Figure 1). The increase in the total prevalence of bipolar disorder is partly attributed to the small rising trend in prevalence in the 8MM, combined with underlying demographic changes in the respective markets.
Even though this disease has a moderately high prevalence, there are limited epidemiological data for bipolar disorder analysing age and sex-specific trends and country variations. Disease diagnosis has also changed over time with each new Diagnostic and Statistical Manual (DSM) criterion, making temporal analysis difficult. As a result, it is highly likely that a significant number of patients have delayed diagnosis.
Patients with bipolar disorder are at higher risk of premature death, with one in five patients estimated to die by suicide in their lifetime. Bipolar disorders are better managed when the condition is diagnosed earlier. As complications such as anxiety disorders and psychotic symptoms are associated with delay in diagnosis, this highlights the need for the development of health strategies for early diagnosis. To facilitate early diagnosis, barriers to access the mental health services should be removed and people should be encouraged to seek medical care at the earliest symptoms of this disease.
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