Background: The prevalence of bipolar spectrum disorders in the community is under debate
and the prescription of antidepressant drugs (ADs) in bipolar depression appears to be an
underestimated problem.
Objectives: To evaluate the prevalence of bipolar disorders by means of a screening instrument
in seven communities within six regions of Italy and evaluate the appropriateness and number
of prescriptions for ADs in bipolar depression.
Methods: Study design: community survey. Study population: samples randomly drawn, after
stratification from the adult population of municipal records. Sample size: 4999 people from
seven communities within six regions of Italy. Tools: questionnaire on psychotropic drug consumption,
prescription, health services utilization; Structured Clinical Interview NP for DSM-IV
modified (ANTAS); Mood Disorder Questionnaire (MDQ). Training: interviewers were trained
psychologists or medical doctors. Study limitations: the population studied did not represent a
nationally representative multistage clustered area probability sample of households.
Results: 3398 subjects were interviewed (68% of recruited sample). Positivity at MDQ (MDQ+)
was higher in males (3.4% vs. 2.8%) but the difference was not significant (OR=1.2, P=0.37).
The association between MDQ+ and Major Depressive Disorder (MDD) was statistically significant
for both males (OR=14.9, Pb0.0001) and females (OR=8.3, Pb0.001); 30% of subjects
with MDQ+ and MDD lifetime diagnosis were taking ADs.
Conclusions: These overall rates of being MDQ+ are similar to community surveys conducted
within USA and the use of ADs in people with MDQ+ and MDD diagnoses are.
