Berkson's bias and the mood dimensions of bipolar disorder

E. J. Regeer*, L. Krabbendam, R. De Graaf, M. Ten Have, W. A. Nolen, J. Van Os

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

25 Citations (Scopus)

Abstract

In this paper we examined whether manic and depressive dimensions independently contribute to mental health service use and determined the degree of comorbidity between manic and depressive dimensions in individuals with and without mental health service use. If both depressive and manic episodes independently influence help-seeking behaviour, a higher level of comorbidity between these dimensions would be found in clinical as compared to nonclinical samples (i.e. Berkson's Bias). Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a prospective epidemiological survey in a representative sample of the Dutch population (N = 7076). Dimensions of depression and mania and mental health service use (MHSU) were assessed with the Composite International Diagnostic Interview (CIDI) at baseline, and prospectively one and three years later. Logistic regression was used to test whether depressive and manic dimensions both had independent effects on mental health service use. The degree of mania-cornorbidity given the presence of depressive dimension was assessed as a function of MHSU, both retrospectively and prospectively. Manic and depressive dimensions contributed independently to mental health service use. Mania-comorbidity given the presence of depressive dimension was significantly higher in individuals with mental health service use than in those without, both retrospectively (16.7% versus 7.1%, p = 0.000) and prospectively (10.8% versus 6.6%, p = 0.017). We conclude that the bipolar phenotype consists of manic and depressive dimensions that may be much more loosely associated than (Berkson) biased clinical observations Suggest. A dimension-specific approach may be more productive in clarifying the aetiology of mood dysregulation. Copyright (C) 2009 John Wiley & Sons, Ltd.

Original languageEnglish
Pages (from-to)279-286
Number of pages8
JournalInternational Journal of Methods in Psychiatric Research
Volume18
Issue number4
DOIs
Publication statusPublished - Dec-2009

Keywords

  • bipolar disorder
  • Berkson's Bias
  • comorbidity
  • mood dimensions
  • INTERNATIONAL DIAGNOSTIC INTERVIEW
  • MENTAL-HEALTH SURVEY
  • GENERAL-POPULATION
  • MAJOR DEPRESSION
  • PREVALENCE
  • SCHIZOPHRENIA
  • RELIABILITY
  • SPECTRUM
  • CIDI
  • DISABILITY

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