Mood disorders: epidemiology and natural history.

Abstract: In addition to the classical syndromes of major depression and bipolar I disorder other syndromes with different epidemiology and natural history are included in the group of mood disorders. The life-time prevalence of major depression comes up to 4 to 19% of the population. In bipolar I disorder, the classical manic-depressive illness, the life-time prevalence is 1% according to narrow definitions, and approximately 5% according to broader definitions. The life-time prevalence of dysthymia was found to be approximately 3–7% of the population, that of cyclothymia appr. 0.5%. There is no reliable statistical information for the prevalence of other types of mood disorders, but it is changing according to definition and methods. Mood disorders are severe and chronic diseases, most of which can be considered as lifelong disorders. There seems to be a constant risk of recurrence of bipolar disorders and major depression over the life-span from 30 to 40 years after onset up to the age of 70 or more. Men have a significantly earlier onset of first-episode mania and bipolar disorder. Mood disorders have a frequent comorbidity, especially with substance abuse disorders, which can have an unfavourable influence on the course of the illness. Patients with mood disorders have a higher risk of death by suicide than healthy people. The mortality of patients with mood disorders, especially depression, is higher than that of the general population. [Copyright &y& Elsevier]