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Original Research Expression of Depressive Symptoms in a Nonclinical Brazilian Adolescent Sample
Clarice Gorenstein, PhD, Laura Andrade, MD, PhD, Elaine Zanolo, Rinaldo Artes, PhD
(PDF)

Posttraumatic Stress Disorder and General Psychopathology in Children and Adolescents Following a Wildfire Disaster
Brett M McDermott, MBBS, Cert Child Psych, FRANZCP, Erica M Lee, BA, Dip Psych, Marianne Judd, BSc Psych, MEd, Peter Gibbon, PhD
(PDF)

Individual Change in Methylphenidate Use in a National Sample of Children Aged 2 to 11 Years
Elisa Romano, PhD, Raymond H Baillargeon, PhD, Isabel Fortier, PhD, Hong-Xing Wu, MSc4, Philippe Robaey, MD, Mark Zoccolillo, MD, Richard E Tremblay, PhD
(PDF)

An Introduction to Economic Evaluation: What’s in a Name?
Jeffrey S Hoch, MA, PhD, Carolyn S Dewa, MPH, PhD
(PDF)

Recherche Originale *Méthadone et Syndrome d’Apnées du Sommeil
Philippe Durst, MD, Jérôme Palazzolo, MD, PhD, Jean-Pierre Peyrelong, MD, Michel Berger, MD, Michel Chalabreysse, MD, Michel Billiard, PhD, André Vialle, MD
(PDF)

Review Paper
Using Metaanalysis to Evaluate Evidence: Practical Tips and Traps
Raymond W Lam, MD, FRCPC, Sidney H Kennedy, MD, FRCPC
(PDF)

Brief Communication
Experimental Affective Symptoms in Panic Disorder Patients
Thea Overbeek, MD, PhD, Koen Schruers, MD, PhD, Ine Docters van Leeuwen, BSc, Tineke Klaassen, MD, PhD, Eric Griez, MA, MD, PhD
(PDF)

Book Reviews
(PDF)

The Treatment of Drinking
Problems: A Guide for the Helping Professions.
Review by
Nady el-Guebaly, MD, FRCPC

Bipolar Disorder: A Clinician’s Guide to Biological Treatments.
Review by
Review by: Rakesh Jain MD, MPH
Shailesh Jain, MD, MPH


Handbook of Female Psychopharmacology
Review by
Laura Calhoun, FRCPC

Sleep and Dreaming: Scientific Advances and Reconsiderations.
Review by
Alan Douglass, MD

Cognitive-Behavioral Treatment of Obesity. A Clinician’s Guide.
Review by
Hany Bissada, MD, FRCPC

Cognitive Therapy of Personality Disorders. Second Edition.
Review by
W John Livesley

Letters to the Editor
(PDF)

Hemorrhages During Escitalopram–Venlafaxine– Mirtazapine Combination Treatment of Depression

Re: Lorazepam-Induced Prolongation of the QT Interval in a Patient With Schizoaffective Disorder and Complete AV Block

Reply: Lorazepam-Induced Prolongation of the QT Interval in a Patient With Schizoaffective Disorder and Complete AV Block

Lithium-Associated Anencephaly

Aripiprazole-Induced Seizure

Prevalence of Bipolar Disorder and Major Depression Among Patients Seen in Primary and Secondary Care in Finland

The Need for More Community Nursing for Adults With Intellectual Disabilities and Mental Health Problems

Improvement in Tardive Dyskinesia With Aripiprazole Use

Letters to the Editor

Prevalence of Bipolar Disorder and Major Depression Among Patients Seen in Primary and Secondary Care in Finland

Dear Editor:

The underdiagnosis of bipolar disorder (BD) and its frequent misdiagnosis as major depressive disorder (MDD) appear to be major problems in patients with BD. Few studies focus on the prevalence of BD and MDD among primary care and psychiatric service patients. In Finland, more than 66% of the population visit a community health care centre during a year; 5% of the population are treated in primary care for a mental disorder, and 3% receive psychiatric treatment (1).

The Finnish Tampere Depression Project (TADEP) was a study that used the Present State Examination (9th version) to assess the prevalence of BD and MDD in primary and secondary care. The Index of Definition cut- off point of > 4 was used to identify cases of BD (ICD-8 diagnosis 296.1). A DSM-III-R assessment was also carried out. The study setting, patients, and data collection methods are reported in detail elsewhere (2,3).

Results

A total of 437 patients in primary care and 435 patients in secondary care were interviewed. In community health centres, the 1-month and 12-month prevalences of BD were 0.9% and 2.1%, respectively. In community mental health centres, the corresponding figures were 4.4% and 7.6%. In comparison, the 1-month and 12-month prevalence rates of depression were 10.7% and 20.0%, respectively, in primary care, and 49.3% and 56.5%, respectively, in secondary care (3).

Thus, the 1-month and 12-month prevalence rates for depression were 4.8-fold and 3.6-fold, respectively, in primary care and 11.2-fold and 7.4-fold, respectively, in secondary care, compared with the prevalence rates for BD.

Discussion

These results may help in detecting and estimating the proportions of patients with BD in actual clinical practice. However, the possibilities of generalizing from the results are limited, owing to the country-specific health care system. The prevalence and enrichment of BD and unipolar MDD accords with other studies in the sense that BDs represent 10% to 20% of all mood disorders.

References

1. Salokangas RKR, Poutanen O. Depression in primary care—some results of the TADEP project. Psych Fennica 1995;26:33–44.

2. Salokangas RKR, Poutanen O, StengDrd E. Screening for depression in primary care. Development and validation of the Depression Scale (DEPS), a screening instrument for depression. Acta Psychiatr Scand 1995;92:10–6.

3. Salokangas RKR, Poutanen O, StengDrd E, Jähi R, Palo-oja T. Prevalence of depression among patients seen in community health centers and community mental health centers. Acta Psychiatr Scand 1996;93:427–33.

Marko P Sorvaniemi, MD, PhD
Raimo KR Salokangas, MD, MSc, PhD
Turku, Finland