SynthesisEpidemiology and psychiatric sciences2026
Prevalence of unipolar mania in bipolar I disorder: a systematic review and meta-analysis of observational studies.
Synthesis in Epidemiology and psychiatric sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsUnipolar mania (UM), defined by the occurrence of manic episodes without a history of depression, is a topic of debate within the classification of affective disorders. However, its epidemiological burden remains unclear. This systematic review and meta-analysis aimed to estimate the prevalence of UM among individuals with bipolar type I disorder (BD-I) while exploring potential sources of heterogeneity.
methodsThe study protocol was registered in Open Science Framework on 27 March 2025. Embase, MEDLINE and APA PsycInfo were searched. We included observational studies reporting data on UM prevalence rates in adults with BD-I. Pooled prevalence was estimated using the Freeman-Tukey double arcsine transformation, employing a restricted maximum likelihood random-effects model. Subgroup and meta-regression analyses were implemented to explore sources of heterogeneity.
resultsWe included 26 studies, encompassing 35 independent samples and 17,716 individuals with BD-I. The pooled prevalence of UM was 21.1% (95% confidence interval: 15.5-27.4%). Although potential publication bias was detected (Egger's
conclusionsPeople with UM represent a significant subset of BD-I cases worldwide, warranting greater clinical awareness. The observed rate variability emphasizes the impact of sociocultural and methodological factors on UM diagnosis. Further research is necessary to refine diagnostic criteria and evaluate optimal treatment approaches for individuals with UM.
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