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13 - Challenges in the genetics of bipolar disorder

Published online by Cambridge University Press:  10 August 2009

By
Kathleen Marikangas  and
Kelly Yu
Edited by
Andreas Marneros  and
Frederick Goodwin
Kathleen Marikangas
Affiliation:
National Institute of Mental Health National Institutes of Health Bethesda, MD USA
Kelly Yu
Affiliation:
National Institute of Mental Health National Institute of Mental Health Bethesda, MD USA
Andreas Marneros
Affiliation:
Martin Luther-Universität Halle-Wittenburg, Germany
Frederick Goodwin
Affiliation:
George Washington University, Washington DC
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Summary

Epidemiology of mood disorders

Major depressive disorder (MDD) is the leading cause of disability among those age 5 and over, and the second leading source of disease burden, surpassing cardiovascular diseases, dementia, lung cancer, and diabetes (Murray and Lopez, 1996). The dramatic impact of mood disorders on distress to the affected individual and his or her family, lifetime disability, and suicide highlights the importance of etiologic research to inform treatment and prevention.

Community-based rates of mood disorder are essential to deriving estimates of population familial recurrence risk (λ) (Risch, 1990). Population prevalence estimates of mood disorders are available from two community surveys of the USA: the Epidemiologic Catchment Area (ECA) study of five sites in the USA (Robins and Regier, 1991), and the National Comorbidity Survey (NCS) of a probability sample of the USA conducted 10 years later (Kessler et al., 1994). Estimates of base rates of bipolar disorder (or manic episodes) were very low in both studies, averaging 0.8% in ECA and 1.6% in NCS. In contrast, there is a very high lifetime prevalence of MDD in the US population (females, 12% ECA; 21.3% NCS, and males, 5% ECA, 12.7% NCS). Similar base rates of mood disorders have been obtained in international studies as well (Weissman et al., 1996). With respect to demographic factors, the differences between the bipolar and major depression subtypes of mood disorders include the sex ratio that favors women for MDD but is nearly equal for men and women for bipolar disorder, and the age of onset that occurs nearly a decade earlier in MDD than in bipolar disorder (Weissman et al., 1991).

Keywords

adolescentsbipolar disorderbirth defectsgene-environment interactionseasonal affective disordermajor depressive disordermood disorders
Type
Chapter
Information
Bipolar Disorders
Mixed States, Rapid Cycling and Atypical Forms
 , pp. 277 - 310
Publisher: Cambridge University Press
Print publication year: 2005

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