Introduction: The objective was to estimate the rate of subjects who tested positive at a screening for bipolar disorders among the people insured by a French Health Company, and subsequently to measure treatment patterns.
Methods: Cross-sectional postal survey on the "Mutuelle Générale de l'Education Nationale" (MGEN) policyholders. A self-rated questionnaire was sent by mail to 20,099 individuals randomly selected among MGEN policyholders. Tools: questionnaire on socio-demographic variables and health-care use; Mood Disorder Questionnaire (MDQ); Composite International Diagnostic Interview Short Form Self-Administered (CIDI-SA).
Results: Responders were 10,288 (53%). The prevalence of MDQ positivity (MDQ(+)) was 3.6%. The respondents older than 65 showed the lowest frequencies. High frequencies were recorded by the people who had left work because of long term sickness and by people with invalidity. Subjects having a diagnosis of ICD-10 major depression were found to be at risk. Positive subjects had no more contacts with general practitioners than negative subjects; on the contrary they had more contacts with psychiatrists, alternative medicine professionals, psychologists, psychoanalysts, spiritual guides or welfare workers. MDQ+ subjects had a higher risk to use all kinds of psychodrugs, including antidepressants (27.7%, OR=2.7, CI95% 1.9-3.9).
Discussion: The prevalence of MDQ(+) was similar to the surveys in the USA and Italy. The use of ADs in people with MDQ(+) and MDD diagnosis needs to be taken into account when managing the public health-care system. A large rate of positive subjects reported to have used ineffective treatments for bipolar disorders.
Limits: Relative low response rate and observational design.
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