Few studies have estimated the prevalence and correlates of bipolar disorder (BP) in agricultural areas of China. This study examined the one-month and lifetime prevalence of BP, its subtypes and socio-demographic factors in the adult population of Hebei province, a predominantly agricultural area of China.

A multistage, stratified, cluster random sampling method was used to estimate the prevalence and correlates of BP in adults in Hebei province, China. The expanded version of the 12-item General Health Questionnaire (GHQ-12) and the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P/C) were administered to establish the diagnosis of BP.

A total of 20,884 participants were screened. The weighted lifetime prevalence of BP, BP type I (BP-I), type II (BP-II), and BP not otherwise specified (BP-NOS) were 0.20% (95% CI: 0.14-0.26%), 0.13% (95% CI: 0.08-0.18%), 0.03% (95% CI: 0.009-0.06%) and 0.03% (95% CI: 0.009-0.06%), respectively. The weighted one-month prevalence estimates were 0.12% (95% CI: 0.08-0.17%) for BP, 0.07% (95% CI: 0.04-0.11%) for BP-I, 0.03% (95% CI: 0.006-0.05%) for BP-II, and 0.02% (95% CI: 0.003-0.04%) for BP-NOS. Multiple Poisson regression analysis revealed that positive family history of any psychiatric disorder (P<0.001, OR=6.48, 95% CI: 2.53-16.56) was significantly associated with greater risk of BP.

The prevalence of BP in Hebei province appears lower than in most areas of China and other countries. Continued surveillance of BP in China along with the development of primary and tertiary preventative interventions for psychiatric disorders is indicated.

Over the last three decades burgeoning research has shown that anxiety disorder comorbidity is not only highly prevalent in bipolar disorder (BD), but it also adversely impacts the course, outcome, and treatment of BD. The present review provides an overview of the current trends in research on comorbid anxiety and BDs based on prior reviews and meta-analyses (n = 103), epidemiological surveys, and large-scale clinical studies. The results reiterated the fact that at least half of those with BD are likely to develop an anxiety disorder in their lifetimes and a third of them will manifest an anxiety disorder at any point of time. All types of anxiety disorders were equally common in BD. However, there was a wide variation in rates across different sources, with most of this discrepancy being accounted for by methodological differences between reports. Comorbid anxiety disorders negatively impacted the presentation and course of BD. This unfavourable clinical profile led to poorer outcome and functioning and impeded treatment of BD. Despite the extensive body of research there was paucity of data on aetiology and treatment of anxiety disorder comorbidity in BD. Nevertheless, the substantial burden and unique characteristics of this comorbidity has important clinical and research implications.

We conducted a randomized, controlled trial comparing the efficacy of an Integrated Risk Reduction Intervention (IRRI) to a control condition with the objective of improving mood stability and psychosocial functioning by reducing cardiometabolic risk factors in overweight/obese patients with bipolar I disorder.

A total of 122 patients were recruited from our outpatient services and randomly allocated to IRRI (n = 61) or psychiatric care with medical monitoring (n = 61). Individuals allocated to IRRI received psychiatric treatment and assessment, medical monitoring by a nurse, and a healthy lifestyle program from a lifestyle coach. Those allocated to the control condition received psychiatric treatment and assessment and referral, if indicated, for medical problems. A mixed-effects model was used to examine the impact of the interventions on body mass index (BMI). Exploratory moderator analyses were used to characterize those individuals likely to benefit from each treatment approach.

Analyses were conducted on data for the IRRI (n = 58) and control (n = 56) participants with ≥ 1 study visit. IRRI was associated with a significantly greater rate of decrease in BMI (d = -0.51, 95% confidence interval: -0.91 to -0.14). Three variables (C-reactive protein, total cholesterol, and instability of total sleep time) contributed to a combined moderator of faster decrease in BMI with IRRI treatment.

Overweight/obese patients with bipolar disorder can make modest improvements in BMI, even when taking medications with known potential for weight gain. Our finding that a combination of three baseline variables provides a profile of patients likely to benefit from IRRI will need to be tested further to evaluate its utility in clinical practice.