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Eating disorders common in bipolar patients
By Mark Cowen, MedWire News
04 August 2010
J Affect Disord 2010; Advance online publication
Eating disorders affect around one in seven patients with bipolar disorder, are more common in women, and are associated with an earlier age of onset and a more severe course of illness, US study results suggest.
"Substantial clinical and community data indicate that bipolar disorder co-occurs with substance use, anxiety, and impulse control disorders, and that these comorbidities are associated with negative effects on the course, outcome, and treatment response of bipolar disorder," explain Susan McElroy (Craig and Frances Lindner Center of HOPE, Mason, Ohio) and team.
"Another comorbidity which has received far less systematic attention but which may also be important is that between bipolar disorder and eating disorders," they add.
To investigate further, the researchers studied 875 outpatients (56% women) with bipolar I or II disorder who were aged an average of 41.1 years. Bipolar illness characteristics and comorbid Axis I disorders, including the eating disorders anorexia nervosa, bulimia nervosa, and binge eating disorder, were assessed using the Structured Clinical Interview for DSM-IV (SCID-P).
The patients also underwent clinical examinations and were interviewed about demographic factors, family history of psychiatric illness, and historical illness variables, such as age of onset of mood symptoms, rapid cycling, suicide attempts, and course of illness.
In total, 125 (14.3%) patients met criteria for at least one lifetime eating disorder, 104 (83.0%) of whom were women. The most common eating disorder was binge eating (n=77), followed by bulimia nervosa (n=42) and anorexia nervosa (n=27).
Bipolar disorder patients with an eating disorder had a younger current mean age (38.8 vs 41.4 years), a younger mean age at bipolar illness onset (18.2 vs 21.3 years), a greater mean number of prior hypomania/mania episodes (18.9 vs 14.8), and a greater mean number of prior episodes of depression (21.1 vs 17.2) compared with those without an eating disorder.
Bipolar patients with an eating disorder also had a higher mean body mass index (31.1 vs 27.2 kg/m2), and were more likely to have history of rapid cycling and suicide attempts, and a family history of depression, bipolar disorder, alcoholism, and drug abuse than those without an eating disorder.
McElroy and team conclude in the Journal of Affective Disorders: "Our findings are consistent with others suggesting that bipolar disorder may co-occur with eating disorders, and this relationship likely has clinical and theoretical significance."
They add: "Further research examining the overlap of these disorders would therefore appear to be just as important as further research into their differences."
Abstract
By Mark Cowen, MedWire News
04 August 2010
J Affect Disord 2010; Advance online publication
Eating disorders affect around one in seven patients with bipolar disorder, are more common in women, and are associated with an earlier age of onset and a more severe course of illness, US study results suggest.
"Substantial clinical and community data indicate that bipolar disorder co-occurs with substance use, anxiety, and impulse control disorders, and that these comorbidities are associated with negative effects on the course, outcome, and treatment response of bipolar disorder," explain Susan McElroy (Craig and Frances Lindner Center of HOPE, Mason, Ohio) and team.
"Another comorbidity which has received far less systematic attention but which may also be important is that between bipolar disorder and eating disorders," they add.
To investigate further, the researchers studied 875 outpatients (56% women) with bipolar I or II disorder who were aged an average of 41.1 years. Bipolar illness characteristics and comorbid Axis I disorders, including the eating disorders anorexia nervosa, bulimia nervosa, and binge eating disorder, were assessed using the Structured Clinical Interview for DSM-IV (SCID-P).
The patients also underwent clinical examinations and were interviewed about demographic factors, family history of psychiatric illness, and historical illness variables, such as age of onset of mood symptoms, rapid cycling, suicide attempts, and course of illness.
In total, 125 (14.3%) patients met criteria for at least one lifetime eating disorder, 104 (83.0%) of whom were women. The most common eating disorder was binge eating (n=77), followed by bulimia nervosa (n=42) and anorexia nervosa (n=27).
Bipolar disorder patients with an eating disorder had a younger current mean age (38.8 vs 41.4 years), a younger mean age at bipolar illness onset (18.2 vs 21.3 years), a greater mean number of prior hypomania/mania episodes (18.9 vs 14.8), and a greater mean number of prior episodes of depression (21.1 vs 17.2) compared with those without an eating disorder.
Bipolar patients with an eating disorder also had a higher mean body mass index (31.1 vs 27.2 kg/m2), and were more likely to have history of rapid cycling and suicide attempts, and a family history of depression, bipolar disorder, alcoholism, and drug abuse than those without an eating disorder.
McElroy and team conclude in the Journal of Affective Disorders: "Our findings are consistent with others suggesting that bipolar disorder may co-occur with eating disorders, and this relationship likely has clinical and theoretical significance."
They add: "Further research examining the overlap of these disorders would therefore appear to be just as important as further research into their differences."
Abstract
