With the symptoms often starting in early adulthood, bipolar disorder has been thought of traditionally as a lifelong disorder.

"Using two large nationally representative studies, we found that there was a strikingly high peak prevalence of bipolar disorders in emerging adulthood," said David Cicero, doctoral student in the Department of Psychological Sciences in the College of Arts and Science and lead author of the paper.

"During the third decade of life, the prevalence of the disorder appears to resolve substantially, suggesting patients become less symptomatic and may have a greater chance of recovery," he added.

While analysing the data, researchers found an "age gradient" in the prevalence of bipolar disorder, with part of the population appearing to outgrow the disorder.

The study showed that 5.5 to 6.2 percent of people between the ages of 18 and 24 suffer from bipolar disorder, but only about 3 percent of people older than 29 suffer from bipolar disorder.

"Young adults between the ages of 18 and 24 are going through significant life changes and social strain, which could influence both the onset and course of the disorder," said Kenneth J. Sher, Curators' Professor in the Department of Psychological Sciences and co-author of the study.

"During this period of life, young adults are exploring new roles and relationships and begin to leave their parents' homes for school or work. By the mid 20s, adults have begun to adjust to these changes and begin to settle down and form committed relationships," the expert added.

Researchers predict the prevalence of the disorder also could be affected by brain development, particularly the prefrontal ortex, which controls perception, senses, personality and intelligence.

"The maturing of the prefrontal cortex of the brain around 25 years of age could biologically explain the developmentally limited aspect of bipolar disorder," Cicero said.

"Other researchers have found a similar pattern in young adults with alcohol or substance abuse disorders," he added.

The study is published in the Journal of Abnormal Psychology. (ANI)

General Practitioners Write Most Prescriptions for Mental Health Drugs, According to Study

from Thomson Reuters and SAMHSA

ANN ARBOR, Mich., Sept. 30 /PRNewswire/ -- Fifty-nine percent of all prescriptions filled for psychotropic medications are written by general practitioners, according to a research report published this month in Psychiatric Services.

The study, conducted by researchers from Thomson Reuters and the federal Substance Abuse and Mental Health Services Administration (SAMHSA), analyzed prescribing patterns for psychotropic drugs from August 2006 through July 2007.

Of the 472 million prescriptions written for psychotropic medications during the study period, the researchers found that general practitioners prescribed 62 percent of antidepressants, 52 percent of stimulants (mainly drugs to treat attention deficit hyperactivity disorder), 37 percent of antipsychotics, and 22 percent of anti-mania medications. Pediatricians were included as general practitioners and wrote 25 percent of all stimulant prescriptions.

"The important role of general practitioners in prescribing antidepressant medications and treating depression has been documented," the study authors wrote. "However, the extent to which general practitioners are prescribing other types of psychotropic medications has received less emphasis."

Prescribing of psychotropic medications by non-psychiatrists may improve access to treatment for many patients, the study notes. However, the authors cite concerns about whether patients treated by non-specialists receive psychotherapy, medication monitoring, appropriate intensity of treatment, and treatment consistent with evidence-based guidelines. Moreover, they cite recent evidence(1) that primary care physicians often are unable to find outpatient mental health services for their patients.

Primary care plays a large role in psychotropic drug prescribing and will likely continue to do so. The researchers stress that it is important to ensure the quality of psychiatric treatment in general practice settings across a range of psychiatric conditions.

Study authors were Tami L. Mark, Ph.D., and Katharine R. Levit of Thomson Reuters and Jeffrey A. Buck, Ph.D., from the Center for Mental Health Services at SAMHSA. The study was funded by SAMHSA. The researchers used data from IMS Health, a provider of market intelligence to the pharmaceutical and healthcare industries.

Thomson Reuters

Thomson Reuters is the world's leading source of intelligent information for businesses and professionals. We combine industry expertise with innovative technology to deliver critical information to leading decision makers in the financial, legal, tax and accounting, healthcare and science and media markets, powered by the world's most trusted news organization. With headquarters in New York and major operations in London and Eagan, Minnesota, Thomson Reuters employs more than 50,000 people and operates in over 100 countries. Thomson Reuters shares are listed on the Toronto Stock Exchange (TSX: TRI) and New York Stock Exchange (NYSE: TRI). For more information, go to www.thomsonreuters.com.

(1) Cunningham PJ: Beyond parity: primary care physicians' perspectives on access to mental health care. Health Affairs 28:w490-w501,2009

Duke University psychologists Terrie Moffitt and Avshalom Caspi and their collaborators from the UK and New Zealand say that it depends upon how one goes about measuring.

The researchers tracked more than 1,000 New Zealanders from birth to age 32, and came to the conclusion that people vastly underreported the amount of mental illness they had suffered, when asked to recall their history years after the fact.

However, said the researchers, such self-reporting from memory is the basis of much of what we know about the prevalence of anxiety, depression, alcohol dependence and marijuana dependence.

According to Moffitt, longitudinal studies like the Dunedin Study in New Zealand, in which people are tracked over time, are rare and expensive.

"If you start with a group of children and follow them their whole lives, sooner or later almost everybody will experience one of these disorders," said Moffitt, the Knut Schmitt-Nielsen professor of psychology and neuroscience at Duke.

Jane Costello, a professor of Medical Psychology at Duke, points out that similar patterns have been found in the Great Smoky Mountains Study, a similar effort based at Duke, which has tracked 1,400 American children from age 9-13 into their late 20s.

"I think we've got to get used to the idea that mental illness is actually very common. People are growing up impaired, untreated and not functioning to their full capacity because we've ignored it," Costello said.

For years, policy makers and mental health providers have hotly debated the prevalence of mental illness.

Moffitt says that the pharmaceutical and health insurance industries also have a stake in the debate.

While the best retrospective studies have found the incidence of depression from ages 18 to 32 at a rate of about 18 percent, the researchers point out that the latest analysis from the Dunedin Study found 41 percent of that age range had experienced clinically significant depression.

They further reveal that the survey studies have reported a 6 to 17 percent lifetime rate of alcohol dependence between ages 18-32, compared to nearly 32 percent in the Dunedin Study.

"Researchers might begin to ask why so many people experience a disorder at least once during their lifetimes and what this means for the way we define mental health, deliver services and count the economic burdens of mental illness," Moffitt said.

The researcher further says that it could be argued that the diagnostic standards have been set too low, if so many people can be considered mentally ill.

On the other hand, perhaps these findings argue for more and better mental health care because the disorders are more common than anyone had realized.

"There are two opposing camps, and I'm agnostic about that," Moffitt said.

Moffitt believes that these findings may help reduce the stigma against mental illness and mental health care.

New Zealand, for example, has begun a new campaign of public service announcements featuring sports heroes saying they've experienced mental health issues.

Costello said: "If we're serious about this problem, we need to get serious about preventing it. We do know a lot more about prevention now." (ANI)