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Epidemiology and burden of bipolar disorder in Africa: a systematic review of data from Africa

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Abstract

Background

Bipolar disorder impacts negatively on the patient, the family, as well as the society. It taxes the health care services due to a combination of the illness with associated medical and psychiatric comorbidities. In Africa, unfortunately, knowledge of the epidemiology and burden of bipolar disorder is based mainly on studies from the USA and Europe. In this systematic review of literature from Africa, we highlight the epidemiology and burden of bipolar disorder.

Methods

A systematic review of publications from Africa relating to the epidemiology and burden of bipolar disorder was conducted.

Result

Data from community surveys conducted in Nigeria and Ethiopia indicated a lifetime prevalence estimate of 0.1 % to 1.83 for bipolar disorder. Missed diagnosis rate of bipolar disorder was up to 36.2 %. In one study, 8.1 % of the males and 5.4 % of the females reported a previous suicide attempt. A study showed that up to 60 % of patients with bipolar disorder had at least one comorbidity. There were no reports on all-cause mortality and cost of illness.

Conclusion

Bipolar disorder is a major mental health problem in Africa. Scientific findings on bipolar disorder from Africa are consistent with the existing literature from other parts of the world. There still exists a dearth of high quality studies addressing the epidemiological, clinical, social, and economic burden of the disorder.

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References

  1. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE et al (2013) Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 382(9904):1575–1586

    Article  PubMed  Google Scholar 

  2. Dore G, Romans SE (2001) Impact of bipolar affective disorder on family and partners. J Affect Disord 67(1–3):147–158

    Article  CAS  PubMed  Google Scholar 

  3. Simon GE (2003) Social and economic burden of mood disorders. Biol Psychiatry 54(3):208–215

    Article  PubMed  Google Scholar 

  4. Huxley N, Baldessarini RJ (2007) Disability and its treatment in bipolar disorder patients. Bipolar Disord 9(1–2):183–196

    Article  PubMed  Google Scholar 

  5. Pope M, Dudley R, Scott J (2007) Determinants of social functioning in bipolar disorder. Bipolar Disord 9(1–2):38–44

    Article  PubMed  Google Scholar 

  6. Peele PB, Xu Y, Kupfer DJ (2003) Insurance expenditures on bipolar disorder: clinical and parity implications. Am J Psychiatry 160(7):1286–1290

    Article  PubMed  Google Scholar 

  7. Widera E, Chang A, Chen HL (2010) Presenteeism: a public health hazard. J Gen Intern Med 25(11):1244–1247

    Article  PubMed Central  PubMed  Google Scholar 

  8. Laxman KE, Lovibond KS, Hassan MK (2008) Impact of bipolar disorder in employed populations. Am J Manag Care 14(11):757–764

    PubMed  Google Scholar 

  9. Kessler RC, Bedirhan Ustun T (2008) The WHO World Mental Health Surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, Cambridge

  10. Kebede D, Alem A, Shibre T, Negash A, Deyassa N, Beyero T (2005) Socio-demographic correlates of bipolar disorder in Butajira, rural Ethiopia. East Afr Med J 82(1):34–39

    CAS  PubMed  Google Scholar 

  11. Negash A, Alem A, Kebede D, Deyessa N, Shibre T, Kullgren G (2005) Prevalence and clinical characteristics of bipolar I disorder in Butajira, Ethiopia: a community-based study. J Affect Disord 87(2–3):193–201

    Article  CAS  PubMed  Google Scholar 

  12. Fekadu A, Shibre T, Alem A, Kebede D, Kebreab S, Negash A et al (2004) Bipolar disorder among an isolated island community in Ethiopia. J Affect Disord 80(1):1–10

    Article  PubMed  Google Scholar 

  13. Gureje O, Adeyemi O, Enyidah N, Ekpo M, Udofia O, Uwakwe R et al (2008) Mental disorders among adult nigerians: risks, prevalence, and treatment. In: Kessler C, Bedirhan Ustun T (eds) The WHO World Mental Health Surveys: global perspectives on the epidemiology of mental disorders. Cambridge University Press, pp 211–237

  14. Kebede D, Alem A (1999) Major mental disorders in Addis Ababa, Ethiopia. II. Affective disorders. Acta Psychiatr Scand Suppl 397:18–23

    Article  CAS  PubMed  Google Scholar 

  15. Ndetei DM, Khasakhala L, Maru H, Pizzo M, Mutiso V, Ongecha-Owuor FA et al (2008) Clinical epidemiology in patients admitted at Mathari Psychiatric Hospital, Nairobi, Kenya. Social Psychiatry Psychiatric Epidemiol 43(9):736–742

    Article  Google Scholar 

  16. Atwoli L, Ndambuki D, Owiti P, Manguro G, Omulimi N (2012) Short-term diagnostic stability among re-admitted psychiatric in-patients in Eldoret, Kenya. Afr J Psychiatry 15(2):114–118

    CAS  Google Scholar 

  17. Naidoo S, Mkize DL (2012) Prevalence of mental disorders in a prison population in Durban, South Africa. Afr J Psychiatry 15(1):30–35

    Article  CAS  Google Scholar 

  18. Uys H (2013) Prevalence and clinical presentation of HIV positive female psychiatric inpatients. Afr J Psychiatry 16(1):23–28

    CAS  Google Scholar 

  19. Okasha T, Fikry M, Kowailed A, El-Guwiely T, Sadek H (2013) Screening for bipolar disorder among patients undergoing a major depressive episode: report from the BRIDGE study in Egypt. J Affect Disord 147(1–3):217–224

    Article  PubMed  Google Scholar 

  20. Adegbaju DA, Olagunju AT, Uwakwe R (2013) A comparative analysis of disability in individuals with bipolar affective disorder and schizophrenia in a sub-Saharan African mental health hospital: towards evidence-guided rehabilitation intervention. Soc Psychiatry Psychiatr Epidemiol 48(9):1405–1415

    Article  PubMed  Google Scholar 

  21. Bakare MO, Agomoh AO, Eaton J, Ebigbo PO, Onwukwe JU (2011) Functional status and its associated factors in Nigerian adolescents with bipolar disorder. Afr J Psychiatry 14(5):388–391

    Article  CAS  Google Scholar 

  22. Onyeama M, Agomoh A, Jombo E (2010) Bipolar disorder in Enugu, South East Nigeria: demographic and diagnostic characteristics of patients. Psychiatria Danubina 22(Suppl 1):S152–S157

    PubMed  Google Scholar 

  23. Gassab L, Mechri A, Gaha L, Khiari G, Zaafrane F, Zougaghi L (2002) Bipolarity correlated factors in major depression: about 155 Tunisian inpatients. L'Encephale 28(4):283–289

    CAS  PubMed  Google Scholar 

  24. Fekadu A, Kebede D, Alem A, Fekadu D, Mogga S, Negash A et al (2006) Clinical outcome in bipolar disorder in a community-based follow-up study in Butajira, Ethiopia. Acta Psychiatr Scand 114(6):426–434

    Article  CAS  PubMed  Google Scholar 

  25. Ezzaher A, Haj Mouhamed D, Mechri A, Neffati F, Douki W, Gaha L et al (2010) Obesity and dyslipidemia in Tunisian bipolar subjects. Ann Biol Clin 68(3):277–284

    CAS  Google Scholar 

  26. Ezzaher A, Haj MD, Mechri A, Neffati F, Douki W, Gaha L et al (2011) Metabolic syndrome in Tunisian bipolar I patients. Afr Health Sci 11(3):414–420

    PubMed Central  CAS  PubMed  Google Scholar 

  27. Kebede D, Alem A, Shibire T, Deyassa N, Negash A, Beyero T et al (2006) Symptomatic and functional outcome of bipolar disorder in Butajira, Ethiopia. J Affect Disord 90(2–3):239–249

    Article  PubMed  Google Scholar 

  28. Merikangas KR, Jin R, He JP, Kessler RC, Lee S, Sampson NA et al (2011) Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry 68(3):241–251

    Article  PubMed Central  PubMed  Google Scholar 

  29. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M et al (2007) Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 64(5):543–552

    Article  PubMed Central  PubMed  Google Scholar 

  30. Shibre T, Kebede D, Alem A, Negash A, Kibreab S, Fekadu A et al (2002) An evaluation of two screening methods to identify cases with schizophrenia and affective disorders in a community survey in rural Ethiopia. Int J Soc Psychiatry 48(3):200–208

    Article  CAS  PubMed  Google Scholar 

  31. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing

  32. Faravelli C, Guerrini Degl'Innocenti B, Aiazzi L, Incerpi G, Pallanti S (1990) Epidemiology of mood disorders: a community survey in Florence. J Affect Disord 20(2):135–141

    Article  CAS  PubMed  Google Scholar 

  33. National Alliance on Mental Illness. The impact and cost of mental illness: the case of bipolar disorder. Arlington, VA 222032014. http://www.nami.org/Template.cfm?Section=bipolar_disorder&template=/ContentManagement/ContentDisplay.cfm&ContentID=42734. Retrieved 29 Sept 2014

  34. Sanchez-Moreno J, Martinez-Aran A, Tabares-Seisdedos R, Torrent C, Vieta E, Ayuso-Mateos JL (2009) Functioning and disability in bipolar disorder: an extensive review. Psychother Psychosom 78(5):285–297

    Article  CAS  PubMed  Google Scholar 

  35. Manove E, Levy B (2010) Cognitive impairment in bipolar disorder: an overview. Postgrad Med 122(4):7–16

    Article  PubMed  Google Scholar 

  36. Levy B, Manove E (2012) Functional outcome in bipolar disorder: the big picture. Depress Res Treat 2012:949248

    PubMed Central  PubMed  Google Scholar 

  37. Passarotti AM, Sweeney JA, Pavuluri MN (2010) Differential engagement of cognitive and affective neural systems in pediatric bipolar disorder and attention deficit hyperactivity disorder. JINS 16(1):106–117

    PubMed Central  PubMed  Google Scholar 

  38. Rock PL, Goodwin GM, Harmer CJ (2010) The common adolescent bipolar phenotype shows positive biases in emotional processing. Bipolar Disord 12(6):606–615

    Article  PubMed  Google Scholar 

  39. Cannon M, Jones P, Gilvarry C, Rifkin L, McKenzie K, Foerster A et al (1997) Premorbid social functioning in schizophrenia and bipolar disorder: similarities and differences. Am J Psychiatry 154(11):1544–1550

    CAS  PubMed  Google Scholar 

  40. Judd LL, Schettler PJ, Solomon DA, Maser JD, Coryell W, Endicott J et al (2008) Psychosocial disability and work role function compared across the long-term course of bipolar I, bipolar II and unipolar major depressive disorders. J Affect Disord 108(1–2):49–58

    Article  PubMed  Google Scholar 

  41. Judd LL, Akiskal HS, Schettler PJ, Endicott J, Leon AC, Solomon DA et al (2005) Psychosocial disability in the course of bipolar I and II disorders: a prospective, comparative, longitudinal study. Arch Gen Psychiatry 62(12):1322–1330

    Article  PubMed  Google Scholar 

  42. Grande I, Goikolea JM, de Dios C, Gonzalez-Pinto A, Montes JM, Saiz-Ruiz J et al (2013) Occupational disability in bipolar disorder: analysis of predictors of being on severe disablement benefit (PREBIS study data). Acta Psychiatr Scand 127(5):403–411

    Article  CAS  PubMed  Google Scholar 

  43. Mortensen PB, Pedersen CB, Melbye M, Mors O, Ewald H (2003) Individual and familial risk factors for bipolar affective disorders in Denmark. Arch Gen Psychiatry 60(12):1209–1215

    Article  PubMed  Google Scholar 

  44. Tsuchiya KJ, Byrne M, Mortensen PB (2003) Risk factors in relation to an emergence of bipolar disorder: a systematic review. Bipolar Disord 5(4):231–242

    Article  PubMed  Google Scholar 

  45. Weissman MM, Leaf PJ, Tischler GL, Blazer DG, Karno M, Bruce ML et al (1988) Affective disorders in five United States communities. Psychol Med 18(1):141–153

    Article  CAS  PubMed  Google Scholar 

  46. Lloyd T, Kennedy N, Fearon P, Kirkbride J, Mallett R, Leff J et al (2005) Incidence of bipolar affective disorder in three UK cities: results from the AESOP study. Br J Psychiatry 186:126–131

    Article  PubMed  Google Scholar 

  47. Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG et al (1996) Cross-national epidemiology of major depression and bipolar disorder. JAMA 276(4):293–299

    Article  CAS  PubMed  Google Scholar 

  48. Suominen K, Mantere O, Valtonen H, Arvilommi P, Leppamaki S, Paunio T et al (2007) Early age at onset of bipolar disorder is associated with more severe clinical features but delayed treatment seeking. Bipolar Disord 9(7):698–705

    Article  PubMed  Google Scholar 

  49. Perlis RH, Dennehy EB, Miklowitz DJ, Delbello MP, Ostacher M, Calabrese JR et al (2009) Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study. Bipolar Disord 11(4):391–400

    Article  PubMed Central  PubMed  Google Scholar 

  50. Weissman MM, Kidd KK, Prusoff BA (1982) Variability in rates of affective disorders in relatives of depressed and normal probands. Arch Gen Psychiatry 39(12):1397–1403

    Article  CAS  PubMed  Google Scholar 

  51. Kebede D, Alem A, Deyassa N, Shibre T, Negash A, Beyero T (2003) Socio-demographic correlates of depressive disorder in Butajira, rural Ethiopia. Cent Afr J Med 49(7–8):78–83

    CAS  PubMed  Google Scholar 

  52. Carney CP, Jones LE (2006) Medical comorbidity in women and men with bipolar disorders: a population-based controlled study. Psychosom Med 68(5):684–691

    Article  PubMed  Google Scholar 

  53. Kahn JP (2006) Comorbidity and bipolar disorders. L'Encephale 32(Pt 2):S511–S514

    Article  PubMed  Google Scholar 

  54. McElroy SL, Altshuler LL, Suppes T, Keck PE Jr, Frye MA, Denicoff KD et al (2001) Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am J Psychiatry 158(3):420–426

    Article  CAS  PubMed  Google Scholar 

  55. Fajutrao L, Locklear J, Priaulx J, Heyes A (2009) A systematic review of the evidence of the burden of bipolar disorder in Europe. Clin Pract Epidemiol Ment Health 5:3

  56. Latalova K, Kamaradova D, Prasko J (2014) Suicide in bipolar disorder: a review. Psychiatr Danubina 26(2):108–114

    Google Scholar 

  57. Pompili M, Gonda X, Serafini G, Innamorati M, Sher L, Amore M et al (2013) Epidemiology of suicide in bipolar disorders: a systematic review of the literature. Bipolar Disord 15(5):457–490

    Article  PubMed  Google Scholar 

  58. Goldberg JF, Harrow M, Grossman LS (1995) Course and outcome in bipolar affective disorder: a longitudinal follow-up study. Am J Psychiatry 152(3):379–384

    Article  CAS  PubMed  Google Scholar 

  59. MacQueen GM, Young LT, Joffe RT (2001) A review of psychosocial outcome in patients with bipolar disorder. Acta Psychiatr Scand 103(3):163–170

    Article  CAS  PubMed  Google Scholar 

  60. Marwaha S, Durrani A, Singh S (2013) Employment outcomes in people with bipolar disorder: a systematic review. Acta Psychiatr Scand 128(3):179–193

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, University of Ibadan, Ibadan, Nigeria

    Oluyomi Esan

  2. Department of Medicine, University College Hospital, Ibadan, Nigeria

    Arinola Esan

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  1. Oluyomi Esan
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  2. Arinola Esan
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Correspondence to Oluyomi Esan.

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Esan, O., Esan, A. Epidemiology and burden of bipolar disorder in Africa: a systematic review of data from Africa. Soc Psychiatry Psychiatr Epidemiol 51, 93–100 (2016). https://doi.org/10.1007/s00127-015-1091-5

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