Prevalence of bipolar disorder in the general population: a Reappraisal Study of the Netherlands Mental Health Survey and Incidence Study

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Abstract
Objective:  The Netherlands Mental Health Survey and Incidence Study (NEMESIS) is a Dutch population study using a fully structured interview (Composite International Diagnostic Interview, CIDI), administered by trained interviewers. Based on all three assessments of NEMESIS, 2.4% of the respondents were identified with lifetime bipolar disorder (DSM‐III‐R).The primary aim of the study was to estimate the prevalence of bipolar disorder in the same population based on a semistructured interview administered by clinicians.Method:  Seventy‐four persons identified with a lifetime CIDI/DSM‐III‐R bipolar disorder and 40 persons with a major depressive disorder (MDD) were reinterviewed with the Structured Clinical Interview for DSM (SCID).Results:  Based on the SCID, 30 of 74 respondents with a CIDI/DSM‐III‐R bipolar disorder and eight of 40 respondents with MDD met DSM‐IV criteria for bipolar disorder or cyclothymia, corresponding with an adjusted lifetime prevalence in these groups of 1% (95% CI: 0.7–1.3%) and 4.2% (95% CI: 1.6–6.9%) respectively.Conclusion:  Compared with the SCID, the CIDI on the one hand overdiagnoses bipolar disorder but on the other hand underdiagnoses bipolar disorder.