There are certain limitations to our study. First, this was a
household survey that excluded those who were institutionalized.
Second, the data was based on respondents’ self-report and there
could be an element of recall bias and under-reporting. Third, we
did not establish the prevalence of substance use disorders and
thus were unable to determine the comorbidity of substance
abuse in bipolar patients, which is a common comorbidity that
considerably influences the severity and impairs functioning.