Special research reportValidity of the assessment of bipolar spectrum disorders in the WHO CIDI 3.0
Section snippets
The NCS-R survey design
The NCS-R was administered face-to-face to a sample of 9282 adult respondents between February 2001 and April 2003. The sample was based on a multi-stage clustered area probability design described in more detail elsewhere (Kessler et al., 2004b). Informed consent was obtained verbally prior to data collection. Consent was verbal rather than written to maintain consistency with the baseline NCS (Kessler et al., 1994). The response rate was 70.9%. Respondents were given a $50 incentive for
Aggregate concordance
The lifetime prevalence estimates (standard error in parentheses) of DSM-IV BP-I, BP-II, and sub-threshold BPD in the weighted SCID clinical reappraisal sample are 1.0% (0.6), 1.7% (0.7), and 1.4% (0.6), respectively, for a total prevalence estimate in the SCID of 4.0% compared to 4.4% in the CIDI. (Table 1) As noted above, these prevalence estimates are conservative, as they are based on the assumption that all main survey respondents who failed to endorse a CIDI BPD stem question would have
Limitations
The results reported here are limited by the fact that the clinical reappraisal sample was small and included no NCS-R respondents who denied the CIDI diagnostic stem questions for mania–hypomania. The issue of omitted NCS-R respondents who denied the CIDI BPD stem questions is of special importance in that this design feature led us to assume that all SCID cases of BPD were captured in the sub-sample of NCS-R respondents who endorsed one of the two CIDI diagnostic stem questions. There are
Conclusions
Within the context of these limitations, the results reported here suggest that the prevalence of DSM-IV bipolar spectrum disorder is at least 4.0% and, given the limitations noted above, probably higher. The CIDI 3.0 assessment of DSM-IV BPD has good concordance with independent SCID diagnoses both at the aggregate level (i.e., in terms of yielding unbiased estimates of prevalence) and at the individual level (i.e., in terms of classifying individual cases). The results also show that a fairly
Acknowledgements
The National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute of Drug Abuse, the Substance Abuse and Mental Health Services Administration, the Robert Wood Johnson Foundation (Grant # 044780), and the John W. Alden Trust. Additional support for preparation of this paper was provided by BristolMyersSquibb. Collaborating NCS-R investigators include Ronald C. Kessler (Principal
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