{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T10:14:10Z","timestamp":1772792050921,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2009,8,25]],"date-time":"2009-08-25T00:00:00Z","timestamp":1251158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Methods Psych Res"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In this paper we examined whether manic and depressive dimensions independently contribute to mental health service use and determined the degree of comorbidity between manic and depressive dimensions in individuals with and without mental health service use. If both depressive and manic episodes independently influence help\u2010seeking behaviour, a higher level of comorbidity between these dimensions would be found in clinical as compared to non\u2010clinical samples (i.e. Berkson's Bias). Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), a prospective epidemiological survey in a representative sample of the Dutch population (<jats:italic>N<\/jats:italic> = 7076). Dimensions of depression and mania and mental health service use (MHSU) were assessed with the Composite International Diagnostic Interview (CIDI) at baseline, and prospectively one and three years later. Logistic regression was used to test whether depressive and manic dimensions both had independent effects on mental health service use. The degree of mania\u2010comorbidity given the presence of depressive dimension was assessed as a function of MHSU, both retrospectively and prospectively. Manic and depressive dimensions contributed independently to mental health service use. Mania\u2010comorbidity given the presence of depressive dimension was significantly higher in individuals with mental health service use than in those without, both retrospectively (16.7% versus 7.1%, <jats:italic>p<\/jats:italic> = 0.000) and prospectively (10.8% versus 6.6%, <jats:italic>p<\/jats:italic> = 0.017). We conclude that the bipolar phenotype consists of manic and depressive dimensions that may be much more loosely associated than (Berkson) biased clinical observations suggest. A dimension\u2010specific approach may be more productive in clarifying the aetiology of mood dysregulation. <jats:italic>Copyright \u00a9 2009 John Wiley &amp; Sons, Ltd.<\/jats:italic><\/jats:p>","DOI":"10.1002\/mpr.290","type":"journal-article","created":{"date-parts":[[2009,8,25]],"date-time":"2009-08-25T06:36:31Z","timestamp":1251182191000},"page":"279-286","source":"Crossref","is-referenced-by-count":20,"title":["Berkson's bias and the mood dimensions of bipolar disorder"],"prefix":"10.1002","volume":"18","author":[{"given":"E.J.","family":"Regeer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Krabbendam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"De Graaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Ten 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