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1.
This study was designed to document eating disorder symptoms in a well-defined sample of patients with bipolar disorder and to evaluate the relationship of current loss of control over eating (LOC) to demographic and clinical features hypothesized to characterize bipolar patients at risk for disordered eating. Eighty-one patients enrolled in the Bipolar Disorder Center for Pennsylvanians provided demographic information and completed the Structured Clinical Interview for DSM-IV Axis I Disorders. The Eating Disorder Examination was administered by independent clinicians to evaluate current and lifetime eating disorder symptomatology. Twenty-one percent of participants met DSM-IV criteria for a lifetime eating disorder, and 44% reported a history of LOC. Patients who endorsed weekly LOC during the past six months (n=18) were heavier, had more atypical depressive symptoms, and were more likely to have a lifetime substance use disorder compared to patients in the rest of the sample (n=63). These findings indicate that eating disorder symptoms are prevalent in patients with bipolar disorder and are associated with obesity and other psychiatric morbidity. Screening for eating disorders in bipolar patients is warranted, as intervention may minimize distress and improve treatment outcome.  相似文献   

2.

Purpose

To study the prevalence of metabolic syndrome in patients with bipolar disorder.

Material and method

By using purposive random sampling 200 patients with bipolar disorder receiving treatment were evaluated for presence of metabolic syndrome using International Diabetes Federation (IDF) and modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria.

Results

Eighty patients fulfilled IDF criteria and 82 patients met NCEP ATP-III criteria for metabolic syndrome. There was significant concordance between these two criteria sets for metabolic syndrome (Kappa value 0.979, p < 0.015). Among the individual parameters studied — increased waist circumference (70.1%) was the most common abnormality, followed by increased blood pressure (44.5%) and increased triglycerides levels (42%). Compared to patients without metabolic syndrome, patients with metabolic syndrome had significantly higher body mass index and higher percentage of them (74.4% vs 51.7%) were more than 35 years of age. Logistic regression analysis revealed that these two variables significantly predicted metabolic syndrome.

Conclusion

Findings of the present study suggest that abdominal obesity is the most common abnormality and metabolic syndrome is best predicted in patients with bipolar disorder by higher age and higher body mass index.  相似文献   

3.

Background

Clinical studies have shown that bipolar patients have increased serum uric acid levels. High serum uric acid levels could play a role contributing to high prevalence of metabolic syndrome. Metabolic syndrome is known to increase the risk of developing a number of life threatening diseases including coronary heart disease, hypertension, and type 2 diabetes. This study investigated the association between hyperuricemia and metabolic syndrome and its components in individuals suffering from bipolar disorders.

Methods

This study recruited 318 inpatients suffering from bipolar disorders from Beijing Hui-Long-Guan Hospital in China and 160 healthy subjects from the same region as the controls. We used National Cholesterol Education Program Adult Treatment Panel III Adapted criteria (NCEP ATP-III A) for the diagnosis of metabolic syndrome. Hyperuricemia was determined as serum uric acid level above 420?μmol/L in men and 360?μmol/L in women (N Engl J Med 359(17):1811–1821, 2008).

Results

Among 318 bipolar patients, there was higher prevalence of metabolic syndrome (42.5%) and hyperuricemia (27.7%) than healthy controls (21.9 and 11.9%). Bipolar patients with metabolic syndrome had increased prevalence of hyperuricemia (OR?=?3.0, CI95 [1.7–5.4]). Hypertriglyceridemia and larger waist circumference (WC) were associated with hyperunicemia (OR?=?1.8, CI95 [1.1–3.1], OR?=?1.9, CI95 [1.1–3.4]). Hyperuricemia was associated with metabolic syndrome in bipolar patients (p?<?0.001) and especially with hypertriglyceridemia (OR?=?1.9, CI95 [1.1–3.1] and increased WC (OR?=?2.1 [1.2–4.0]). Bipolar patients over 50?years of age and hyperuricemia were highly prone to develop metabolic syndrome (OR?=?14.0, CI95 [5.0–39.0]).

Conclusions

Hyperuricemia was highly associated with development of metabolic disorder particularly for aged patients suffering from bipolar disorders. Early prevention of hyperuricemia and metabolic syndrome may lead better life for bipolar patients when they get older.
  相似文献   

4.
OBJECTIVE: This study was aimed at evaluating general medical burden in a group of 111 patients with bipolar I disorder. METHODS: Data were drawn from participants entering the Bipolar Disorder Center for Pennsylvanians (BDCP) protocol. General medical burden was assessed by completing the Cumulative Illness Rating Score (CIRS) from chart review. RESULTS: The mean age of the sample was 42.1 (11.5), mean CIRS total score was 4.7 (2.9), and mean number of categories endorsed was 3.4 (1.7). Medical burden showed a positive relationship with increasing age and with duration of illness. CIRS scores and number of organ/system categories endorsed were significantly higher in patients with more than 21 years of illness than in patients with 0-9 years of illness (p<.0001) or with 10-20 years of illness (p<.0001). Medical burden was related to duration of illness even after controlling for age. The most frequently endorsed illness categories were cardiovascular disease, (with hypertension and hyperlipidemia being the most frequent conditions) and endocrine/metabolic (with obesity, thyroid dysfunction, and type 2 diabetes being the most common conditions). CONCLUSIONS: Patients with bipolar disorder carry a substantial burden of general medical conditions, related to age and duration of illness. These results suggest that the development and testing of specific interventions that target medical risk factors and medical burden in patients with bipolar disorder are urgently needed, especially early in the course of the illness, when patients appear to accumulate medical comorbidity at a rapid rate.  相似文献   

5.
OBJECTIVES: To examine the pathophysiologic mechanisms that may link bipolar disorder and metabolic syndrome and to discuss whether the consequences of metabolic syndrome underlie a substantive portion of the premature morbidity and mortality observed in persons with bipolar disorder. DATA SOURCES: A MEDLINE search, citing articles from 1966 onward, supplemented by a review of bibliographies, was conducted to identify relevant studies. Bipolar disorder, mood disorder, metabolic syndrome, diabetes, cardiovascular illness, and obesity were used as keywords. Criteria used to select studies included (1) English language, (2) published studies with original data in peer-reviewed journals, and (3) studies that confirmed the nature of the mood disorder examined. RESULTS: Ninety-seven studies met criteria and were reviewed for evidence of dysregulation in various physiologic systems. Bipolar disorder and metabolic syndrome share features of hormonal, immunologic, and autonomic nervous system dysregulation. CONCLUSION: Lifestyle features may account, in part, for the premature mortality observed in bipolar disorder, but the somatic correlates of the illness may also predispose patients to metabolic syndrome and the consequent increased risk of diseases such as diabetes and vascular disease.  相似文献   

6.
Objective: Bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD). We aim to quantify the prevalence of misdiagnosed bipolar disorder among the depression population and evaluate the quality-of-life (QOL) impact of misdiagnoses.Method: Data were collected from 2 self-administered, cross-sectional studies in 2003. Patients participating in The Bipolar Disorder Misdiagnosis Study (N = 1156) were previously diagnosed with depression, experienced a depressive episode within the past year, and had no previous diagnosis of bipolar disorder or schizophrenia. Patients who experienced a manic episode in the past year, based on DSM-IV criteria, were classified as misdiagnosed. Patients participating in The Bipolar Disorder Project (N = 1214) self-reported a diagnosis of bipolar disorder and were recruited through community mental health centers and support groups. Quality of life was assessed via the Psychological General Well-Being (PGWB) Index and Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8). Demographic differences between groups were controlled using linear regression models.Results: Of the diagnosed MDD sample, 14.3% met criteria for misdiagnosed bipolar disorder. When controlling for demographic differences, the PGWB overall score for the misdiag-nosed averaged 12.77 (p < .001) points lower than that of MDD patients and 9.55 (p < .001) points lower than that of diagnosed bipolar disorder patients. The average SF-8 mental component summary score for the misdiagnosed was 5.85 (p < .001) points lower than that of MDD patients and 3.18 (p = .002) points lower than that of diagnosed bipolar disorder patients.Conclusion: Misdiagnosis is associated with poorer QOL than MDD or diagnosed bipolar disorder, which are recognized as having a considerable impact on QOL.  相似文献   

7.
ObjectiveSummarize data on metabolic syndrome (MS) in bipolar disorder (BD).MethodsA systematic review of the literature was conducted using the Medline, Embase and PsycInfo databases, using the keywords “metabolic syndrome”, “insulin resistance” and “metabolic X syndrome” and cross-referencing them with “bipolar disorder” or “mania”. The following types of publications were candidates for review: (i) clinical trials, (ii) studies involving patients diagnosed with bipolar disorder or (iii) data about metabolic syndrome. A 5-point quality scale was used to assess the methodological weight of the studies.ResultsThirty-nine articles were selected. None of studies reached the maximum quality score of 5 points. The prevalence of MS was significantly higher in BD individuals when compared to a control group. The analysis of MS subcomponents showed that abdominal obesity was heterogeneous. Individuals with BD had significantly higher rates of hypertriglyceridemia than healthy controls. When compared to the general population, there were no significant differences in the prevalence of low HDL-c in individuals with BD. Data on hypertension were also inconclusive. Rates of hyperglycemia were significantly greater in patients with BD compared to the general population.ConclusionsThe overall results point to the presence of an association between BD and MS, as well as between their subcomponents.  相似文献   

8.
ObjectiveTo assess the differences in the prevalence of the metabolic syndrome (MetS) and their components in young adults with bipolar disorder (BD) and major depressive disorder (MDD) in a current depressive episode.MethodsThis was a cross-sectional study with young adults aged 24–30 years old. Depressive episode (bipolar or unipolar) was assessed using the Mini International Neuropsychiatric Interview – Plus version (MINI Plus). The MetS was assessed using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III).ResultsThe sample included 972 subjects with a mean age of 25.81 (±2.17) years. Both BD and MDD patients showed higher prevalence of MetS compared to the population sample (BD = 46.9%, MDD = 35.1%, population = 22.1%, p < 0.001). Higher levels of glucose, total cholesterol and LDL cholesterol, Body Mass Index, low levels of HDL cholesterol, and a higher prevalence of abdominal obesity were observed in both BD and MDD individuals with current depressive episode compared to the general population. Moreover, there was a significant difference on BMI values in the case of BD and MDD subjects (p = 0.016).ConclusionMetabolic components were significantly associated with the presence of depressive symptoms, independently of the diagnosis.  相似文献   

9.
BACKGROUND: Obesity is a major public health concern in the United States and its prevalence is increasing. Individuals with bipolar disorder tend to be overweight, and their treatment may exacerbate obesity and increase the risk of concurrent medical disease in this population. METHOD: This retrospective report from the Pittsburgh Study of Maintenance Therapies in Bipolar Disorder examines the prevalence of overweight (body mass index [BMI] = 25.0-29.9) and obesity (BMI > or = 30.0) in 50 consecutive subjects with bipolar I disorder (DSM-IV) and evaluates weight change during acute treatment and the first year of maintenance treatment. RESULTS: At entry into the study, 34 (68%) of the patients in this sample with bipolar disorder were obese or overweight. The prevalence of obesity was high (16 [32%] of the 50 patients in our sample). The number of previous depressive episodes contributed to the likelihood of being overweight or obese at study entry. During the trial, most of the weight gain occurred during acute treatment rather than during maintenance treatment. During acute treatment, the amount of increase of BMI was positively related to the score on the Hamilton Rating Scale for Depression and negatively related to the score on Bech-Rafaelsen Mania Scale. There was a negative relationship between BMI and tendency to gain weight, during both acute and maintenance treatment. CONCLUSION: The high prevalence of obesity in subjects with bipolar disorder emphasizes the need for specific treatment strategies and programs for weight control for these individuals. The minimal weight gain during the maintenance phase, the relationship of acute depressive episodes to weight gain, and the fact that stabilization on maintenance medication may facilitate the participation in specific interventions for weight loss provide additional support for the practice of maintenance treatment.  相似文献   

10.

Objective

Bipolar disorder is associated with a high risk of suicide. Many clinical characteristics and, recently, biomarkers have been studied with the aim to find useful predictors of suicidality. The role of serum lipids has also been explored albeit with conflicting results; however, few studies have been focused on patients with bipolar disorder.Aim of our study is to investigate whether serum cholesterol, triglycerides, HDL-c and metabolic syndrome are associated with lifetime suicide attempts in a large naturalistic sample of patients with bipolar disorder.

Methods

220 patients with bipolar disorder were included. History of lifetime suicide attempts was systematically and retrospectively assessed for each patient. Blood exams testing total cholesterol, triglycerides, and HDL-c levels were performed, and metabolic syndrome was diagnosed according to NCEP ATP-III modified criteria. Serum lipid levels and metabolic syndrome were compared in patients with or without history of suicide attempt. According to a theory that links impulsivity and violence with low cholesterol, the association between lipid levels and violent suicidal behavior was also assessed.

Results

Lifetime suicide attempts rate was 32.3%. There were no statistically significant differences between patients with and without lifetime suicide attempts in cholesterol, triglycerides, HDL-c levels, and the prevalence of metabolic syndrome. No differences in the same variables were found in violent suicide attempters compared with nonviolent ones. Clinical characteristics such as gender, low education, higher number of manic and depressive episodes, and taking more medications for bipolar disorder were associated with lifetime suicide attempts.

Conclusions

Our results do not support the hypothesis of a strong association between serum lipid levels and suicide in patients with bipolar disorder.  相似文献   

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