THE NATIONAL DEPRESSIVE AND MANIC-DEPRESSIVE ASSOCIATION (DMDA) SURVEY OF BIPOLAR MEMBERS

Members of the National Depressive and Manic-Depressive Association wh o have bipolar disorder were surveyed. 59% of respondents had their fi rst symptoms during childhood or adolescence. Long delays between symp tom onset, treatment-seeking, and receipt of a bipolar diagnosis were common. 45% of respondents currently experience frequent recurrences. Child/adolescent onset was associated with a positive family history, depressive or mixed initial symptoms, and frequent recurrence, with pr edominantly depressive symptoms. Frequent recurrences were associated with depressive or mixed initial symptoms and depressive episodes, but not with medication non-compliance. Both child/adolescent onset and f requent recurrence were associated with increased social morbidity, wh ich was diminished by effective treatment. Respondents with frequent r ecurrences were less likely to be treated with mood-stabilizers, more likely to be treated with anti-depressants, or anxiolytics, and more l ikely to report past anxiety symptoms and diagnoses. 13% of respondent s had no medical insurance, and 15% had failed to take medicine for fi nancial reasons. The treatment of bipolar illness could be enhanced by (a) public health efforts to promote early diagnosis and treatment; ( b) ensuring adequate trials of mood-stabilizers for patients with freq uent recurrences; (c) further research on bipolar disorder with promin ent anxiety symptoms; and (c) improved access to mental health care.