Bipolar disorder: Prevalence, help-seeking and use of mental health care in England. Findings from the 2014 Adult Psychiatric Morbidity Survey

Abstract

BackgroundTo date, the lifetime prevalence of Bipolar Disorder (BD) and BD patients’ access to mental health care in England has not been systematically studied. MethodsWe used data from the Adult Psychiatric Morbidity Survey 2014 (N = 7546). The Mood Disorders Questionnaire (MDQ) was used to screen for BD. Associations between sociodemographic and clinical variables and use of mental health services were investigated. Weighted regression modelling established factors associated with being in receipt of care for mental health problems over the last year. ResultsThe lifetime prevalence of BD in the community in England was 1.7%. Approximately 40% had not received mental health care in the last year, and only 16.9% had received BD specific treatment. 14.6% had asked for a specific form of help but not received it. Psychopathology differed between individuals who successfully sought care and those who didn't. Obtaining care was independently associated with female sex (p<0.0001, odds ratio(OR):4.65 (Confidence Interval (CI):2.18–10.30), unemployment (p = 0.02, OR: 2.65 (C.I: 1.23–5.88) and suicidal ideation (p = 0.04, OR: 3.36, (C.I: 1.04–10.89). LimitationsThe MDQ is less sensitive than some of the longer measures, especially in the general population. Some between-group comparisons may have suffered from limited power. ConclusionsThe lifetime prevalence of BD in England was similar to rates worldwide. Most people with BD had not received any specific treatment for the condition in the last year, while 1 in 7 had requested specific help but did not receive it. Secondary mental health services in England for BD appear suboptimal.