The lifetime prevalence of bipolar disorders and the use of antidepressant drugs in bipolar depression in Italy

BackgroundThe prevalence of bipolar spectrum disorders in the community is under debate and the prescription of antidepressant drugs (ADs) in bipolar depression appears to be an underestimated problem.ObjectivesTo evaluate the prevalence of bipolar disorders by means of a screening instrument in seven communities within six regions of Italy and evaluate the appropriateness and number of prescriptions for ADs in bipolar depression.MethodsStudy design: community survey. Study population: samples randomly drawn, after stratification from the adult population of municipal records. Sample size: 4999 people from seven communities within six regions of Italy. Tools: questionnaire on psychotropic drug consumption, prescription, health services utilization; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Mood Disorder Questionnaire (MDQ). Training: interviewers were trained psychologists or medical doctors. Study limitations: the population studied did not represent a nationally representative multistage clustered area probability sample of households.Results3398 subjects were interviewed (68% of recruited sample). Positivity at MDQ (MDQ+) was higher in males (3.4% vs. 2.8%) but the difference was not significant (OR = 1.2, P = 0.37). The association between MDQ+ and Major Depressive Disorder (MDD) was statistically significant for both males (OR = 14.9, P < 0.0001) and females (OR = 8.3, P < 0.001); 30% of subjects with MDQ+ and MDD lifetime diagnosis were taking ADs.ConclusionsThese overall rates of being MDQ+ are similar to community surveys conducted within USA and the use of ADs in people with MDQ+ and MDD diagnoses are.