Bipolar disorder — statistics quick reference¶
Last updated: 2026-09-03
Figures are transcribed from live-retrieved PubMed abstracts. Estimates that appear to conflict are shown separately because populations, criteria, settings and methods differ.
Prevalence, service use and disability¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| Lifetime bipolar I prevalence | 0.6% | 61,392 adults, 11 countries, WMH-CIDI cross-sectional surveys | Merikangas 2011, PMID 21383262 |
| Lifetime bipolar II prevalence | 0.4% | Same WMH sample/method | Merikangas 2011, PMID 21383262 |
| Lifetime subthreshold bipolar prevalence | 1.4% | Same WMH sample/method | Merikangas 2011, PMID 21383262 |
| Lifetime bipolar-spectrum prevalence | 2.4% | Same WMH sample/method | Merikangas 2011, PMID 21383262 |
| 12-month bipolar I prevalence | 0.4% | Same WMH sample/method | Merikangas 2011, PMID 21383262 |
| 12-month bipolar II prevalence | 0.3% | Same WMH sample/method | Merikangas 2011, PMID 21383262 |
| 12-month subthreshold bipolar prevalence | 0.8% | Same WMH sample/method | Merikangas 2011, PMID 21383262 |
| 12-month bipolar-spectrum prevalence | 1.5% | Same WMH sample/method | Merikangas 2011, PMID 21383262 |
| Severe role impairment during depression | 74.0% | WMH bipolar-spectrum respondents with depression | Merikangas 2011, PMID 21383262 |
| Severe role impairment during mania | 50.9% | WMH bipolar-spectrum respondents with mania | Merikangas 2011, PMID 21383262 |
| Any comorbid disorder | ~75% | WMH lifetime bipolar-spectrum cases | Merikangas 2011, PMID 21383262 |
| Mental-health-system contact, low-income countries | 25.2% | WMH lifetime bipolar-spectrum cases | Merikangas 2011, PMID 21383262 |
| Median bipolar treatment gap | 50.2% untreated | 37 community epidemiology studies | Kohn 2004, PMID 15640922 |
| Australian 12-month prevalence, recalibrated CIDI | 0.9% | 2007 national survey | Mitchell 2013, PMID 22906117 |
| Australian 12-month prevalence, unrecalibrated CIDI | 1.7% | Same survey; older algorithm | Mitchell 2013, PMID 22906117 |
| Singapore lifetime prevalence | 1.2% | Nationally representative CIDI survey | Subramaniam 2013, PMID 23017543 |
| Singapore 12-month prevalence | 0.6% | Same survey | Subramaniam 2013, PMID 23017543 |
| Singapore any other lifetime mental disorder | 69.4% | Lifetime bipolar cases | Subramaniam 2013, PMID 23017543 |
| Singapore chronic physical condition | 52.6% | Lifetime bipolar cases | Subramaniam 2013, PMID 23017543 |
| African community lifetime prevalence range | 0.1–1.83% | Systematic review of Nigeria/Ethiopia and other African evidence | Esan 2016, PMID 26155900 |
| African missed-diagnosis rate | Up to 36.2% | African systematic review | Esan 2016, PMID 26155900 |
| Disability association | OR 3.41 (95% CI 1.04–11.12) | Portugal WMH survey | Antunes 2018, PMID 29366849 |
Diagnosis, spectrum and mixed features¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| DSM-5 mixed features in major depressive episodes | 11.6% (95% CI 7.9–16.7) | 17 studies/20 samples, literature 2013–2020 | Na 2021, PMID 33418368 |
| DSM-5 mixed features in mania/hypomania | 26.8% (17.0–39.5) | Same meta-analysis | Na 2021, PMID 33418368 |
| ≥3 opposite-polarity symptoms, all mood episodes | 27.8% (27.2–28.5) | 17 reports, 19,198 participants | Vázquez 2018, PMID 28922738 |
| ≥3 opposite-polarity symptoms, bipolar depression | 35.2% (33.8–36.5) | Same systematic review | Vázquez 2018, PMID 28922738 |
| ≥3 opposite-polarity symptoms, bipolar mania/hypomania | 35.1% (32.9–37.3) | Same systematic review | Vázquez 2018, PMID 28922738 |
| ≥3 opposite-polarity symptoms, MDD depression | 23.8% (23.0–24.5) | Same systematic review | Vázquez 2018, PMID 28922738 |
| Mixed features and attempt history | OR 2.37 (1.42–3.94) | 8 studies, 3,070 bipolar participants | Bartoli 2020, PMID 32697704 |
| Mixed features and anxiety disorder | OR 2.67 (1.28–5.57) | Manic/hypomanic subgroup | Bartoli 2020, PMID 32697704 |
| Mixed features and rapid cycling | OR 4.23 (1.29–13.81) | Manic/hypomanic subgroup | Bartoli 2020, PMID 32697704 |
| Mixed-feature manic severity | SMD −0.40 (−0.65 to −0.16) | Manic/hypomanic subgroup | Bartoli 2020, PMID 32697704 |
| HCL-32 sensitivity | 81% | Psychiatric services; 53-study accuracy meta-analysis, n=21,542 | Carvalho 2015, PMID 25451435 |
| HCL-32 specificity | 67% | Same | Carvalho 2015, PMID 25451435 |
| MDQ sensitivity | 66% | Psychiatric services | Carvalho 2015, PMID 25451435 |
| MDQ specificity | 79% | Psychiatric services | Carvalho 2015, PMID 25451435 |
| BSDS sensitivity | 69% | Psychiatric services | Carvalho 2015, PMID 25451435 |
| BSDS specificity | 86% | Psychiatric services | Carvalho 2015, PMID 25451435 |
| MDQ sensitivity at cutoff 7 | 43% | Primary care/general population | Carvalho 2015, PMID 25451435 |
| MDQ specificity at cutoff 7 | 95% | Primary care/general population | Carvalho 2015, PMID 25451435 |
Course, recurrence and functioning¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| Ten-year sustained remission/improvement | About 50% | 34 bipolar I participants, prospective follow-up | Goldberg 2004, PMID 15306137 |
| Ten-year functional decline | 30–40% | Same cohort | Goldberg 2004, PMID 15306137 |
| Normal work performance at every follow-up | <50% | Same cohort | Goldberg 2004, PMID 15306137 |
| Remained syndromally remitted at 12 months | 87.6% | 398 remitted bipolar I patients, prospective Spanish cohort | Montoya 2010, PMID 20557947 |
| Free of subsyndromal symptoms at 12 months | 79.9% | Same cohort | Montoya 2010, PMID 20557947 |
| Normal functioning at 12 months | 53.5% | Same cohort | Montoya 2010, PMID 20557947 |
| Early-onset diagnostic stability | 73–100% over 10 years | 42 publications, 15 cohorts, 10,187 patients | Cirone 2021, PMID 33800274 |
| Recovery from index early-onset episode | 81.5–100% | Same review | Cirone 2021, PMID 33800274 |
| Early-onset recurrence | 35–67% | Same review | Cirone 2021, PMID 33800274 |
| Early-onset five-year attempt prevalence | 18–20% | Five cohorts in review | Cirone 2021, PMID 33800274 |
| Hypersomnia prevalence | 29.9% (25.8–34.1) | 10 studies, 1,824 bipolar patients | Grigolon 2019, PMID 30611064 |
| Maltreatment and earlier onset | OR 1.85 (1.43–2.40) | Meta-analysis, 14 studies/5,733 participants | Agnew-Blais 2016, PMID 26873185 |
| Maltreatment and rapid cycling | OR 1.89 (1.45–2.48) | 8 studies/3,010 participants | Agnew-Blais 2016, PMID 26873185 |
| Maltreatment and more manic episodes | OR 1.26 (1.09–1.47) | 7 studies/3,909 participants | Agnew-Blais 2016, PMID 26873185 |
| Maltreatment and more depressive episodes | OR 1.38 (1.07–1.79) | 8 studies/4,025 participants | Agnew-Blais 2016, PMID 26873185 |
Psychiatric comorbidity¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| ADHD among adults with bipolar disorder | 17.11% (13.05–21.59) | 71 studies, 646,766 participants | Schiweck 2021, PMID 33515607 |
| Bipolar disorder among adults with ADHD | 7.95% (5.31–11.06) | Same meta-analysis | Schiweck 2021, PMID 33515607 |
| Earlier bipolar onset with comorbid ADHD | 3.96 years (2.65–5.26) | Same meta-analysis | Schiweck 2021, PMID 33515607 |
| Bipolar odds in adults with versus without ADHD | OR 8.7 (5.47–13.89) | Large studies: ADHD n=550,748; controls n=14,546,814 | Hartman 2023, PMID 37149075 |
| Any anxiety disorder in pediatric bipolar disorder | 44.7% | 37-study meta-analysis | Yapıcı Eser 2020, PMID 31899546 |
| Pediatric panic disorder | 12.7% | Same | Yapıcı Eser 2020, PMID 31899546 |
| Pediatric generalized anxiety disorder | 27.4% | Same | Yapıcı Eser 2020, PMID 31899546 |
| Pediatric social phobia | 20.1% | Same | Yapıcı Eser 2020, PMID 31899546 |
| Pediatric separation anxiety | 26.1% | Same | Yapıcı Eser 2020, PMID 31899546 |
| Pediatric OCD | 16.7% | Same | Yapıcı Eser 2020, PMID 31899546 |
| Pediatric ADHD, weighted mean | 48% | 167-study systematic review | Frías 2015, PMID 25545605 |
| Pediatric substance-use disorder | 31% | Same review | Frías 2015, PMID 25545605 |
| SUD association with male sex | OR 2.191 (1.121–4.281) | Adult bipolar systematic review/meta-analysis | Messer 2017, PMID 28419959 |
| SUD association with prior suicidality | OR 1.758 (1.156–2.674) | Same | Messer 2017, PMID 28419959 |
| Cannabis-use disorder and attempt history | OR 1.35; P=0.01 | 11 studies, 6,375 participants; cross-sectional | Bartoli 2019, PMID 31121199 |
Mortality, suicide and cardiovascular health¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| All-cause mortality SMR | 2.05 (1.89–2.23) | 31-study bipolar meta-analysis | Hayes 2015, PMID 25735195 |
| Natural-cause SMR | 1.64 (1.47–1.83) | Same | Hayes 2015, PMID 25735195 |
| Unnatural-cause SMR | 7.42 (6.43–8.55) | Same | Hayes 2015, PMID 25735195 |
| Suicide SMR | 14.44 (12.43–16.78) | Same | Hayes 2015, PMID 25735195 |
| Circulatory mortality SMR | 1.73 (1.54–1.94) | Same | Hayes 2015, PMID 25735195 |
| Respiratory mortality SMR | 2.92 (2.00–4.23) | Same | Hayes 2015, PMID 25735195 |
| Infection mortality SMR | 2.25 (1.70–3.00) | Same | Hayes 2015, PMID 25735195 |
| Neoplasm mortality SMR | 1.14 (1.10–1.21) | Same | Hayes 2015, PMID 25735195 |
| Pooled life expectancy | 66.88 years (64.47–69.28) | 11 studies, 96,601 people | Chan 2022, PMID 35184778 |
| Female life expectancy | 70.51 years (68.61–72.41) | Subgroup meta-analysis | Chan 2022, PMID 35184778 |
| Male life expectancy | 64.59 years (61.16–68.03) | Subgroup meta-analysis | Chan 2022, PMID 35184778 |
| Years of potential life lost | 12.89 (12.72–13.07) | 13 studies, 128,989 people | Chan 2022, PMID 35184778 |
| Stroke incidence HR | 1.43 (1.24–1.66) | 7 studies, 13,305,007 participants | Yuan 2022, PMID 34052937 |
| Stroke mortality HR | 1.54 (1.09–2.18) | Same | Yuan 2022, PMID 34052937 |
| Hypertension incidence-rate ratio | 1.27 (1.15–1.40) | Prospective-study meta-analysis | Ayerbe 2018, PMID 28915505 |
| Post-ACS mortality RR, SMI | 1.40 (1.21–1.62) | 22 studies, 12,235,501 participants | Chan 2022, PMID 35786737 |
| Post-ACS revascularization OR, SMI | 0.57 (0.49–0.67) | Same | Chan 2022, PMID 35786737 |
| Cardioprotective medication RR, SMI | 0.89 (0.85–0.94) | Same | Chan 2022, PMID 35786737 |
| Incident heart failure RR | 1.95 (1.31–2.91); I²=80.1% | 4 retrospective cohorts contributing the bipolar estimate (7 cohorts in the review overall); adjusted estimates | Dong 2026, PMID 42668911 |
| Lifetime suicide attempts, bipolar I with severe cannabis-use disorder | 33.71% (21.64–48.36) | NESARC-III; n=753 bipolar I / 35,556 without bipolar I; adjusted | Uelman 2026, PMID 42664567 |
| Lifetime suicide attempts, severe cannabis-use disorder without bipolar I | 16.65% (13.17–20.83) | Same NESARC-III comparison | Uelman 2026, PMID 42664567 |
Metabolic and reproductive health¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| Obesity association | OR 1.77 (1.40–2.23) | 9 cross-sectional studies; 12,259 cases/615,490 controls | Zhao 2016, PMID 27262632 |
| Global metabolic-syndrome prevalence | 32.7% (25.9–40.2) | 56 studies, 780,099 participants | Salari 2025, PMID 40921519 |
| Chinese inpatient metabolic-syndrome prevalence | 33% (29–37) | 11 studies, 1,562 participants | Tao 2022, PMID 35738391 |
| Impaired glucose metabolism and chronic course | OR 2.96 (1.69–5.17) | Fixed-effect synthesis, k=2 | Miola 2023, PMID 37086806 |
| Impaired glucose metabolism and rapid cycling | OR 2.88 (1.59–5.21) | Fixed-effect synthesis, k=2 | Miola 2023, PMID 37086806 |
| Impaired glucose metabolism and poor stabilizer response | OR 6.74 (1.04–43.54) | Fixed-effect synthesis, k=2 | Miola 2023, PMID 37086806 |
| Valproate and PCOS | OR 6.74 (1.66–27.32) | Women with bipolar disorder, meta-analysis | Zhang 2016, PMID 27160812 |
| Valproate and menstrual disorder | OR 1.81 (1.02–3.23) | Same | Zhang 2016, PMID 27160812 |
| Valproate and hyperandrogenism | OR 2.02 (1.11–3.65) | Same | Zhang 2016, PMID 27160812 |
Pregnancy and postpartum¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| Pregnancy recurrence | 71% | 89 euthymic pregnant women, prospective cohort | Viguera 2007, PMID 18056236 |
| Pregnancy recurrences depressive/mixed | 74% | Same cohort | Viguera 2007, PMID 18056236 |
| Pregnancy recurrences in first trimester | 47% | Same cohort | Viguera 2007, PMID 18056236 |
| Recurrence with lamotrigine continuation | 30% | 26 pregnant women | Newport 2008, PMID 18402631 |
| Recurrence after stopping all mood stabilizers | 100% | Same small cohort | Newport 2008, PMID 18402631 |
| Overall postpartum relapse | 35% (29–41) | 37 articles, 5,700 deliveries | Wesseloo 2016, PMID 26514657 |
| Postpartum relapse, medication-free pregnancy | 66% (57–75) | Bipolar subgroup | Wesseloo 2016, PMID 26514657 |
| Postpartum relapse, prophylaxis | 23% (14–37) | Bipolar subgroup | Wesseloo 2016, PMID 26514657 |
| Bipolar I postpartum relapse | 39% (29–49) | 12 studies, 3,595 deliveries | Sharma 2024, PMID 38258551 |
| Manic/mixed among postpartum relapses | 38% (28–50) | Same | Sharma 2024, PMID 38258551 |
| Lithium-exposed cardiac malformations | 2.41% | 663 first-trimester exposures, Medicaid 2000–2010 | Patorno 2017, PMID 28591541 |
| Unexposed cardiac malformations | 1.15% | 1,322,955 unexposed pregnancies | Patorno 2017, PMID 28591541 |
| Lithium cardiac-malformation adjusted RR | 1.65 (1.02–2.68) | Same cohort | Patorno 2017, PMID 28591541 |
| Lithium >900 mg/day cardiac RR | 3.22 (1.47–7.02) | Dose subgroup | Patorno 2017, PMID 28591541 |
| Any lithium-associated congenital anomaly | OR 1.81 (1.35–2.41); NNH 33 | 29-study systematic review; 13 quantitative | Fornaro 2020, PMID 31623458 |
| Lithium-associated cardiac anomaly | OR 1.86 (1.16–2.96); NNH 71 | Same | Fornaro 2020, PMID 31623458 |
| Valproate-exposed autism by age eight | 2.7%; aHR 2.4 (1.7–3.3) | Nordic epilepsy cohort | Bjørk 2022, PMID 35639399 |
| Valproate-exposed intellectual disability | 2.4%; aHR 2.5 (1.7–3.7) | Same | Bjørk 2022, PMID 35639399 |
| Induction/planned caesarean, treated bipolar | 37.5%; OR 2.12 (1.68–2.67) | Swedish registry, 320 treated women | Bodén 2012, PMID 23137820 |
| Induction/planned caesarean, untreated bipolar | 30.9%; OR 1.57 (1.30–1.90) | Swedish registry, 554 untreated women | Bodén 2012, PMID 23137820 |
| Gestational diabetes with bipolar diagnosis | aOR 1.75 (1.15–2.70) | Hong Kong 2003–2018 cohort | Chan 2024, PMID 38914040 |
| Pregnant bipolar cohort receiving psychotropics | 59.6% | Hong Kong, 302 women, 2003–2018 | Kan 2022, PMID 35151952 |
| Polypharmacy during pregnancy | 23.3% | Same cohort | Kan 2022, PMID 35151952 |
Evidence-broadening additions¶
| Measure | Estimate | Population / method / data year | Source |
|---|---|---|---|
| Mean specialist-care diagnostic delay | 6.46 years | Hungarian administrative cohort, n=8,935 | Lublóy 2020, PMID 32075625 |
| Pediatric bipolar symptom-index separation | g 1.30 (95% CI 0.98–1.62) | 28 studies, 115 effect sizes; accuracy moderated by informant/content/comparator | Alcaíno 2024, PMID 39103165 |
| Pediatric bipolar psychotic-feature prevalence | 16%–87.5% | Review; range driven by age, sampling and interview method | Pavuluri 2004, PMID 15094254 |
| Twelve-month mood-episode relapse | 46% | Prospective actigraphy cohort, 88/189 | Esaki 2021, PMID 34645802 |
| Pooled recurrence across heterogeneous studies | 43.6% | 34 studies, 33,500 participants | Bai 2026, PMID 41176250 |
| Sleep disturbance and recurrence | OR 3.69 | Same synthesis; nonrandomized prognostic association | Bai 2026, PMID 41176250 |
| Maintenance monotherapy versus placebo | OR 0.42 (0.34–0.51) | 22 enriched RCTs, n=7,773; 24–104 weeks | Nestsiarovich 2022, PMID 34489127 |
| Valproate acute-mania response | RR 1.42 (1.19–1.71) | High-quality review within overview of 26 systematic reviews | Mari 2024, PMID 39500601 |
| Youth risperidone manic-symptom effect | SMD −1.18 (−1.45 to −0.92) | Network meta-analysis, 18 RCTs/2,844 participants overall | Vita 2025, PMID 39128561 |
| Continued adjunctive antidepressant: any episode | HR 0.68 (0.43–1.10) | 52-week versus 8-week continuation after bipolar I depression remission | Yatham 2023, PMID 37530824 |
| Continued adjunctive antidepressant: depressive episode | HR 0.43 (0.25–0.75) | Same prematurely stopped RCT | Yatham 2023, PMID 37530824 |
| Continued adjunctive antidepressant: mania/hypomania | HR 2.28 (0.86–6.08) | Same prematurely stopped RCT | Yatham 2023, PMID 37530824 |
| Lithium-associated mean eGFR difference | −11.14 mL/min/1.73 m² (−16.61 to −5.68) | Lithium versus non-lithium meta-analysis, n=1,622; I²=86% | Macaron 2026, PMID 41727809 |
| Lithium-associated annual eGFR decline difference | 0.13 mL/min/1.73 m²/year (0.06–0.20) faster | Meta-analysis, n=13,280 | Macaron 2026, PMID 41727809 |
| Group psychoeducation and relapse | OR 0.43 (0.28–0.62) | 11 group-therapy RCTs, n=1,191; I²=41% | Tan 2022, PMID 36421612 |
| OCD prevalence in bipolar disorder | 10.9% lifetime (7.8–14.4); 11.2% cross-sectional (7.6–15.3) | 39 lifetime and 29 cross-sectional studies | Ferentinos 2020, PMID 31818777 |
| Waking sedentary time in severe mental illness | 476 min/day (407–545) | 69 studies, n=35,682; mixed severe-mental-illness diagnoses | Vancampfort 2017, PMID 28941119 |
| Smoking and suicide-attempt history | OR 1.70 (1.48–1.95) | 22 psychosis/bipolar studies, n=11,452; publication inflation detected | Pietschnig 2024, PMID 39328818 |
| Infant serum lithium | Mean 0.23 mEq/L | 13 case reports/series, 39 dyads | Imaz 2019, PMID 31551795 |
| Passive relapse-prediction AUC range | 0.70–0.88 | 52 studies, 4,814 participants; 75% high risk of bias, mostly internal validation | Fang 2026, PMID 42106724 |
Known conflicts and caveats¶
- Diagnostic algorithms can nearly double prevalence in the same survey (Mitchell 2013, PMID 22906117).
- Mixed-feature prevalence differs substantially between strict DSM-5 criteria and broader opposite-polarity symptom counts (Na 2021, PMID 33418368; Vázquez 2018, PMID 28922738).
- Most mortality, metabolic and pregnancy estimates have high heterogeneity and should not be treated as universal patient-level probabilities.
- Pregnancy comparisons against the general population mix medication effects with bipolar illness, smoking, obesity, healthcare use and other confounding; treated-versus-untreated bipolar comparisons remain observational.
- Relative risks, absolute risks, prevalence and standardized mortality ratios answer different questions and are not interchangeable.
- Treatment effects from responder-enriched maintenance trials should not be treated as effectiveness estimates in unselected practice (Nestsiarovich 2022, PMID 34489127).
- Digital-prediction AUCs are predominantly internally validated and likely optimistic; calibration and clinical utility remain unestablished (Fang 2026, PMID 42106724).