Medical burden in bipolar disorder: findings from the Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study (Bipolar CHOICE )
Year: 2014
Type: article
Abstract: OBJECTIVES: Individuals with bipolar disorder have high rates of other medical comorbidity, which is associated with higher mortality rates and worse course of illness. The present study examined common predictors of medical comorbidity. METHODS: The Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study (Bipolar CHOICE) enrolled 482 participants with bipolar I or bipolar II disorder in a six-month, randomized comparative effectiveness trial. Baseline assessments included current and lifetime DSM-IV-TR diagnoses, demographic information, psychiatric and medical history, severity of psychiatric symptoms, level of functioning, and a fasting blood draw. Medical comorbidities were categorized into two groups: cardiometabolic (e.g., diabetes, hyperlipidemia, and metabolic syndrome) and non-cardiovascular (e.g., seizures, asthma, and cancer). Additionally, we looked at comorbid substance use (e.g., smoking and drug dependence). RESULTS: We found that 96.3% of participants had at least one other medical comorbidity. Older age predicted a greater likelihood of having a cardiometabolic condition. Early age of onset of bipolar symptoms was associated with a lower chance of having a cardiometabolic condition, but a greater chance of having other types of medical comorbidity. Additional predictors of other medical comorbidities in bipolar disorder included more time spent depressed, less time spent manic/hypomanic, and longer duration of illness. Medications associated with weight gain were associated with low high-density lipoprotein and abnormal triglycerides. CONCLUSIONS: There appears to be a substantial medical burden associated with bipolar disorder, highlighting the need for collaborative care among psychiatric and general medical providers to address both psychiatric and other medical needs concomitantly in this group of patients.
Source: Bipolar Disorders
DOI: 10.1111/bdi.12243
Authors: Louisa G Sylvia, Richard C Shelton, David E Kemp, Emily E Bernstein, Edward S Friedman, Benjamin D Brody, Susan L McElroy, Vivek Singh, Mauricio Tohen, Charles L Bowden, Terence A Ketter, Thilo Deckersbach, Michael E Thase, Noreen A Reilly‐Harrington, Andrew A Nierenberg, Dustin J Rabideau, Gustavo Kinrys, James H Kocsis, William V Bobo, Masoud Kamali, Melvin G McInnis, Joseph R Calabrese
Institutions: Harvard University, Massachusetts General Hospital, University of Alabama at Birmingham, UAB Medicine, Case Western Reserve University, University of Pittsburgh Medical Center, Cornell University, Weill Cornell Medicine, Lindner Center of HOPE, University of Cincinnati, The University of Texas at San Antonio Health Science Center, University of New Mexico, Stanford Medicine, Stanford University, University of Pennsylvania, Mayo Clinic, University of Michigan
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Abbott Laboratories, American Psychiatric Publishing, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi, Teva Pharmaceutical Industries, American Psychological Association, Brandeis University, Sunovion, National Alliance for Research on Schizophrenia and Depression, Wellcome Trust, Jazz Pharmaceuticals, Massachusetts Medical Society, Mylan, University of Oxford, National Research Foundation, Università di Pisa, H. Lundbeck A/S, National Institutes of Health, U.S. Food and Drug Administration, Agency for Healthcare Research and Quality, Michigan Institute for Clinical and Health Research, National Institute on Aging, National Institute of Mental Health, National Institute on Drug Abuse, UCB Pharma
OpenAlex ID: W2139745472