DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191647

The prevalence of bipolar spectrum disorder in medical students of Pakistan

Muhammad Hassaan Ali, Hamza Maqsood, Muhammad Hassan Jalil, Hafiz Farhan Shoukat, Hassan Abdullah Shakeel

Abstract


Background: Bipolar affective disorder is cyclic swinging of mood between mania or hypo-mania and depression. Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 1 to 3% in the general population. Despite a growing body of knowledge on bipolar spectrum disorder (BSD), relatively little is known about the clinical characteristics of BSD in medical students. This study evaluates the prevalence and severity of BSD in medical students in relation to certain socio-demographic factors like age, sex and class of education.

Methods: A questionnaire based study was done on 298 medical students of Nishtar Medical University, Multan and Shaikh Zayed Medical College, Rahim Yar Khan chosen on basis of random sampling to test the prevalence of bipolar spectrum disorders using Mood Disorder questionnaire (MDQ). Out of these students 161 were males and 137 were females. Students were interviewed to obtain information about age, sex and academic year of education.

Results: According to mood disorder questionnaire scoring, of the total 298 students 80 (26.84%) screened positive for bipolar spectrum disorder (BSD). Among 80 students who screened positive for BSD 43 (53.75%) are males while 37 (46.25%) are females. Class-wise distribution of BSD is as follows: Out of 80 students screened positive 15 (18.75%) are from 2nd year, 22 (27.5%) from 3rd year and 43 (53.75) from 4th year. Age-wise distribution of BSD is as following: Students of age 19, 20, 21, 22 and 23 years suffering from BSD were 5 (6.25%), 17 (21.25%), 23(28.75),22 (27.5%) and 13 (16.25%) respectively.

Conclusions: In our study, the estimated rate of prevalence for bipolar spectrum disorder among medical students of Pakistan is 26.84%. There was no significant difference in prevalence on the basis of gender. Prevalence was increasing with both age and class wise distribution.


Keywords


Bipolar, Depression, Euthymic, Stigma

Full Text:

PDF

References


Cowen M. International prevalence and correlates of bipolar disorder elucidated. Arch Gen Psychiatry. 2011;68:241-51.

Anderson IM, Haddad PM, Scott J. Bipolar disorder. BMJ. 2012 Dec 27;345:e8508.

American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013:123-154.

Judd LL, Akiskal HS, Schettler PJ, Coryell W, Endicott J, Maser JD, et al. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch General Psychiatry. 2003 Mar 1;60(3):261-9.

Dunner DL. Clinical consequences of under-recognized bipolar spectrum disorder. Bipolar Disord. 2003;5:456-63.

Prien RF, Potter WZ. NIMH workshop report on treatment of bipolar disorder. Psychopharmacol Bull. 1990;26:409-27.

Hirschfeld RMA, Weissman MM. Risk factors for major depression and bipolar disorder. In: Neuropsychopharmacolgy: The Fifth Generation of Progress. Editors Kenneth L. Davis Dennis Charney Joseph T. Coyle Charles Nemeroff, Philadelphia; 2002.

Health Guide. Bipolar Disorder risk factors: In New York Times; 2012.

Martinez MS, Fristad MA. Conversion from bipolar disorder not otherwise specified (BP-NOS) to bipolar I or II in youth with family history as a predictor of conversion. J Affect Disord. 2013;148(2-3):431-4.

Serretti A, Chiesa A, Calati R, Linotte S, Sentissi O, Papageorgiou K, et al. Influence of family history of major depression, bipolar disorder, and suicide on clinical features in patients with major depression and bipolar disorder. Eur Arch Psychiatry Clin Neurosci. 2013;263(2):93-103.

Akiskal HS, Pinto O. The evolving bipolar spectrum. Prototypes I, II, III, and IV. Psychiatr Clin North Am. 1999;22:517-34.

Akiskal HS, Akiskal KK, Lancrenon S, Hantouche EG, Fraud JP, Gury C, et al. Validating the bipolar spectrum in the French National EPIDEP Study: overview of the phenomenology and relative prevalence of its clinical prototypes. J Affect Disord. 2006;96:197-205.

Hantouche EG, Angst J, Akiskal HS. Factor structure of hypomania: interrelationships with cyclothymia and the soft bipolar spectrum. J Affect Disord. 2003;73:39-47.

Ghaemi SN, Ko JY, Goodwin FK. The bipolar spectrum and the antidepressant view of the world. J Psychiatr Pract. 2001;7:287-97.

Benazzi F. Bipolar II disorder: epidemiology, diagnosis and management. CNS Drugs. 2007;21:727-40.

Youngstrom EA. Psychological science and bipolar disorder in children and adolescents. Psychological Science Agenda. 2006;20:1-4.

Ghuloum S, Bener A, Abou-Saleh MT. Prevalence of mental disorders in adult population attending primary health care setting in Qatari population. JPMA. 2011 Mar 1;61(3):216.

Perälä J, Suvisaari J, Saarni SI, Kuoppasalmi K, Isometsä E, Pirkola S, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch General Psychiatry. 2007 Jan 1;64(1):19-28.

Chisholm D, Ommeren M V, Ayuso-Mateos JL, Saxena S. Cost-effectiveness of clinical interventions for reducing the global burden of bipolar disorder. BJP. 2005;187:559-67.

Burden of Mental Illness. Centres for Disease Control and Prevention; 2011. [Updated 7 July 2011]. [Viewed on 26 February, 2013] Available at: http://www.cdc.gov/mentalhealth/basics/burden. htm.

Geller B, Zimerman B, Williams M, Delbello MP, Frazier J, Beringer L. Phenomenology of prepubertal and early adolescent bipolar disorder: examples of elated mood, grandiose behaviors, decreased need for sleep, racing thoughts and hypersexuality. J Child Adolesc Psychopharmacol. 2002;12:3-9.

Axelson D, Birmaher B, Strober M, Gill MK, Valeri S, Chiappetta L, et al. Phenomenology of children and adolescents with bipolar spectrum disorders. Arch Gen Psychiatry. 2006;63:1139-48.

Ardestani SMS, Gudarzi SS, Shahriari N, Ramezani F, Foroughi M. Patterns of substance abuse among Iranian bipolar inpatients: a descriptive research on existing data. IJABS. 2014;1(1):38-44.