Higher prevalence of bipolar I disorder among Asian and Latino compared to Caucasian patients receiving treatment
Version of Record online: 30 SEP 2010
Copyright © 2010 Blackwell Publishing Asia Pty Ltd
Volume 2, Issue 3, pages 156–165, October 2010
How to Cite
Hwang, S. H.J., Childers, M. E., Wang, P. W., Nam, J. Y., Keller, K. L., Hill, S. J. and Ketter, T. A. (2010), Higher prevalence of bipolar I disorder among Asian and Latino compared to Caucasian patients receiving treatment. Asia-Pacific Psychiatry, 2: 156–165. doi: 10.1111/j.1758-5872.2010.00080.x
- Issue online: 30 SEP 2010
- Version of Record online: 30 SEP 2010
- Received 16 February 2010 Accepted 21 June 2010
- bipolar disorder;
Introduction: There are limited data regarding relationships between race/ethnicity and bipolar disorder. This study assessed such relationships in patients receiving treatment in a university clinic.
Methods: Demographic, illness characteristics, symptom severity, treatment, and care utilization data were collected from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Affective Disorders Evaluation, Mini-International Neuropsychiatric Interview, and the STEP-BD Clinician Rated Packet. Data were compared among 51 Asian, 35 Latino, and 86 Caucasian patients in treatment at the Stanford University Bipolar Disorders Clinic. χ2 tests and analyses of variance were used to assess between-group differences.
Results: Asian and Latino compared to Caucasian patients had significantly higher prevalence of bipolar I disorder (58.8% and 60.0% versus 37.2%, respectively). Asian and Latino patients also had a higher prevalence of history of psychosis, but this was related to the excess of bipolar I disorder, becoming non-significant after controlling for bipolar subtype. The racial/ethnic difference in bipolar subtype prevalence did not appear to be secondary to demographic or socioeconomic differences.
Discussion: The higher prevalence of bipolar I disorder and thus lower prevalence of bipolar II disorder and bipolar disorder not otherwise specified in Asian and Latino patients may be related to under-diagnosis, misdiagnosis, or care underutilization of patients with milder forms of bipolar disorders. Additional research and public health efforts are warranted to further understand the effects of race and ethnicity on the management of bipolar disorders and to enhance timely and accurate diagnosis, culturally sensitive treatment, and optimal care utilization.