Bipolar disorder in adults

Published

Contents
  1. 1. Main facts and figures
  2. 2. By ethnicity and sex
  3. 3. Methodology
  4. 4. Data sources
  5. 5. Download the data

1. Main facts and figures

  • in 2014, there were no meaningful differences between ethnic groups in the percentage of adults who had a positive screening for bipolar disorder
  • the small number of positive screenings for certain ethnic groups means any apparent differences are too uncertain to draw reliable conclusions
  • these figures should not be used as evidence of real differences between ethnic groups in the population as a whole
Things you need to know

A positive screen for bipolar disorder indicates that someone is likely to have bipolar disorder, based on symptoms they have described. A full clinical assessment would be needed for diagnosis. The questions in the Adult Psychiatric Morbidity Survey (APMS) are used to estimate how common bipolar disorder is likely to be in the adult population, but they aren’t used as part of any national screening programme in England.

The survey covers people aged 16 or over who live in private households. It doesn’t include those who live in institutional settings (such as hospitals or prisons) or in temporary housing (such as hostels or bed and breakfasts) or those who sleep rough. People living in such settings are likely to have worse mental health than those living in private households. There were 7,546 respondents to the survey.

These statistics have been age-standardised so comparisons can be made between ethnic groups as if they had the same age profile (an age profile shows the number of people of different ages within an ethnic group). They do not tell you the actual percentage of people in each ethnic group who have or would have a positive screen for bipolar disorder.

Keep in mind when making comparisons between ethnic groups that all survey estimates are subject to a degree of uncertainty as they are based on a sample of the population. The degree of uncertainty is greater when the number of respondents is small, so it will be highest for minority ethnic groups. In this situation, the numbers of respondents in each group were too small to make any conclusions about differences between them.

These statistics are based on participants’ direct responses (as opposed to someone else filling in the survey). As a result, socially undesirable or stigmatised feelings and behaviours may be under-reported. This is a risk with any survey based on self-reported data.

The ethnic groupings used here are broad; there is no breakdown of data for the more specific ethnic groups each contains. Some of the specific ethnic groups have very different experiences to one another. For example, the Black/Black British group could include both recent migrants from Somalia and Black people born in Britain to British parents.

What the data measures

This data estimates the percentage of people aged 16 and older in England who would screen positive for bipolar disorder. Bipolar disorder, previously known as manic depression, is a mental health condition characterised by recurring episodes of depression and mania.

The data for this measure was collected in the Adult Psychiatric Morbidity Survey (APMS) that was conducted in private households across England in 2014. Survey respondents screened positive if they said they had ever experienced 7 or more common symptoms of biopolar disorder, as well as several other symptoms that occur at the same time. These symptoms must also have caused moderate or serious problems with normal day-to-day functioning.

The ethnic categories used in this data

For this data, the number of people surveyed (the ‘sample size’) was too small to draw any firm conclusions about detailed ethnic categories. Therefore, the data is broken down into the following broad groups, based on the ONS harmonised ethnic group questions for use on national surveys.

  • Asian/Asian British
  • Black/Black British
  • Mixed/Multiple
  • White British
  • Other White

2. By ethnicity and sex

Percentage of people aged 16 years and over screening positive for bipolar disorder by ethnicity and sex
Ethnicity All Men Women
% % %
Asian 1.4 2.0 0.7
Black 3.5 2.9 4.0
Mixed/Other 1.8 1.6 2.0
White - British 2.0 2.3 1.8
White - Other 2.0 3.1 1.1

Download table data (CSV) Source data (CSV)

Summary

This data shows that:

  • no meaningful difference between ethnic groups has been observed in terms of the likelihood of screening positive for bipolar disorder

  • the percentage of people screening positive for bipolar disorder ranged from 1.4% to 3.5% depending on their ethnic group; the range was slightly wider when looking only at women, from 0.7% to 4% (but again, these differences are not reliable)

3. Methodology

Respondents to the APMS 2014 were assessed for bipolar disorder based on their answers to the Mood Disorder Questionnaire (MDQ), which asks 13 yes/no questions related to lifetime experience of manic or hypomanic symptoms and is based on the Diagnostic and Statistical Manual of Mental Disorders criteria for bipolar spectrum disorders. Survey respondents screened positive if they said they had ever experienced 7 or more common symptoms of bipolar disorder, as well as several other symptoms that occur at the same time. These symptoms must also have caused moderate or serious problems with normal day-to-day life (for example: being unable to work; having family, money or legal troubles; or getting into arguments or fights).

Each survey involved interviewing a large stratified probability sample of the general population, covering people living in private households. The full adult age range was covered, with the youngest participants aged 16 and the oldest over 100.

The two-phase survey design involved an initial interview with the whole sample, followed up with a structured assessment carried out by clinically trained interviewers with a subset of participants. People were assessed or screened for a range of different types of mental disorder, from common conditions like depression and anxiety disorder through to less common neurological and mental conditions such as psychotic disorder, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD).

The use of a survey to assess mental health conditions is not as reliable as a diagnosis made using a clinical interview. The assessments used have been validated, however, and are among the best available.

The resulting statistics for positive screen for bipolar disorder have been age-standardised. This is because the prevalence of mental disorders is related to age and the age profile can differ considerably between ethnic groups. This adjustment allows comparisons to be made between ethnic groups as if they had the same age profile.

The survey covers people who live in private households. It doesn’t include those who live in institutional settings (such as hospitals or prisons) or in temporary housing (such as hostels or bed and breakfasts) or those who sleep rough. People living in such settings are likely to have worse mental health than those living in private households (Gill et al. 1996; cited in APMS 2014).

Where a selected participant could not take part in a long interview due to a physical or mental health condition, some information about this was recorded by the interviewer on the doorstep. This information may be biased due to it having been collected, often from another household member.

Socially undesirable or stigmatised feelings and behaviours may be underreported. While this is a risk for any study based on self-report data, the study goes some way to minimising this by collecting particularly sensitive information in a self-completion format.

Some people selected for the survey could not be contacted or refused to take part. The achieved response rate (57%) is in line with that of similar surveys (Barnes et al. 2010; cited in APMS 2014). Weighting helps take account of those who were selected for the survey but didn’t take part.

Weighting is used to adjust the results of a survey to make them representative of the population and improve their accuracy. For example, a survey which contains 25% females and 75% males will not accurately reflect the views of the general population, which we know is around 50% male and 50% female.

More detailed information on the weighting used here can be found in the Methods chapter of the Adult Psychiatric Morbidity Survey 2014 (PDF).

Confidence intervals

The confidence intervals for each ethnic group are available in the ‘download the data’.

1.8% of White British women surveyed screened positive for bipolar disorder. This is a reliable estimate of the percentage of White British women in England who are likely to screen positive for bipolar disorder. Because the APMS results are based on a random sample of adults aged 16 or older, however, it’s impossible to be 100% certain of the true percentage.

It’s 95% certain, however, that somewhere between 1.3% and 2.5% of all White British women in England would screen positive for bipolar disorder. In statistical terms, this is a 95% confidence interval. This means that if 100 random samples were taken, then 95 times out of 100 the estimate would fall between the lower and upper bounds of the confidence interval. But 5 times out of 100 it would fall outside this range.

The smaller the survey sample, the more uncertain the estimate and the wider the confidence interval. For example, fewer women from the Black/Black British ethnic group were sampled for this survey than White British women, so we can be less certain about the estimate for the smaller group. This greater uncertainty is expressed by the wider confidence interval of between 1.2% and 12.5%.

Suppression rules and disclosure control

There is no risk to disclosure as the analysis is based on broad ethnic groups, without further disaggregation. Therefore no data has been suppressed. Risk to disclosure has been accounted for with limitations of the level of disaggregation, size of category groupings, and the maintaining of large underlying populations for analysis. No further suppression or other disclosure control has been applied.

Rounding

Percentages have been rounded to one decimal point.

Related publications

Full references for other sources cited in this commentary can be found in the Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014.

Adult Psychiatric Morbidity Survey 2007

Publications using APMS data (PDF)

Quality and methodology information

Further technical information

APMS 2014 Background Data Quality Statement

4. Data sources

Source

Type of data

Survey data

Type of statistic

National Statistics

Publisher

NHS Digital

Publication frequency

Every 7 years (further publications dependent on further surveys being commissioned)

Purpose of data source

The Adult Psychiatric Morbidity Survey (APMS) series provides England's National Statistics for the prevalence of mental illness and treatment access in the adult household population.

5. Download the data

apms_adults_screening_positive_for_bipolar - Spreadsheet (csv) 1 KB

This file contains the following: ethnicity, year, gender, value, denominator, numerator, confidence intervals