Bipolar disorder: prevalence and comorbidity among emergency department patients in Latin-american countries

  • Dr Ruby Castilla-Puentes, Department of Psychiatry School of Medicine, University of North Carolina at Chapel Hill, United States
  • Dr Ricardo Secin, Hospital Angeles del Pedregal, Mexico
  • Dr Arturo Grau, Hospital Jose´ Horwitz, Chile
  • Dr Roxana Galeno, Department of Psychiatry, Neurociencias Institute and University of Mendoza, Mendoza, Argentina, Argentina
  • Dr Marcelo Feijo de Mello, Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil, Brazil
  • Dr Sandra Castilla-Puentes, Department of Anesthesiology,Hospital Regional Duitama, Boyaca, Colombia, Colombia
  • Dr Wilma Castilla-Puentes, Department of Obstetrics and Gynecology, INSA, Boyaca, Colombia, Colombia
  • Dr Carlos Sanchez-Russi, INSA-Colombia, Colombia

Objectives: This study estimated prevalence and comorbidity of bipolar disorder (BPD) among emergency department (ED) patients in Latin America.
Methods: To identify patients with BPD, a combination of DSM IV- criteria interview and a questionnaire screen including the Mood Disorder Questionnaire (MDQ) was used. Data from consecutive 1,505 patients from hospitals in Argentina, Brazil, Chile, Colombia, and Mexico was analyzed.
Results: The prevalence of BPD in this population was 5.6%. The mean age was 37 years, with response rate of 83.0%. Compared to non-BPD patients, BPD patients were more likely to report a diagnosis of asthma (16.7% vs. 9%), thyroid problems (12.8% vs. 5.8%), seizures (23.1% vs. 3.0%), and to suffer of obesity (39.7% vs. 26.9%, all p ≤0.05). BPD patients also had higher rate of alcohol abuse (30.8% vs. 10.0%), attention deficit hyperactivity disorders (50.0% vs. 12%), depression (81.6% vs. 45.7%), obsessive compulsive disorder (20.1% vs. 3.0%), panic disorders (23.1% vs. 12.3%), phobic disorders (11.2% vs. 3.1%), and any anxiety disorder (82.1 %vs. 41.8%). Compared to non-BPD, suicidal plans and attempts were also significant higher in the bipolar group (11.5% vs. 2.8% and 10.3% vs. 1.8% respectively). Multivariate analysis identified ADHD, depression, alcohol abuse, anxiety disorder and last month suicide plans and attempts to be independently associated with BPD.
Conclusion: Patients presenting at ED with irritability, pressure speech, euphoria, those involved in risky behaviors, with suicidal tendencies, anxiety disorders, alcohol abuse, dependence or history of mental health hospitalization in the past 12 months must be assessed for comorbid BPD.