Magazine article Clinical Psychiatry News

Bipolar Disorder, Medical Comorbidities Linked

Magazine article Clinical Psychiatry News

Bipolar Disorder, Medical Comorbidities Linked

Article excerpt

PITTSBURGH -- Patients with bipolar disorder have an unexpectedly high prevalence of medical comorbidities, based on findings from a study of 175 patients.

These 175 patients, with an average age of 35, had a high prevalence of gastrointestinal, musculoskeletal, genitourinary, and other medical comorbidities, Ellen Frank, Ph.D., said at the Sixth International Conference on Bipolar Disorder.

The rates were "very high for such a young population. It stunned us," said Dr. Frank, professor of psychiatry and psychology at the University of Pittsburgh, which sponsored the conference.

If physicians focus only on the psychiatric symptoms of patients with bipolar disorder, they "do their patients a disservice because they also have a lot of medical illness ... associated with poor psychiatric outcomes," she told this newspaper.

The Pittsburgh Study of Maintenance Therapies in Bipolar Disorders was designed to assess the efficacy of a psychosocial therapy as an adjunct to pharmacotherapy. But as part of the study, the participants underwent a thorough medical work-up at baseline.

The initial assessment found large numbers of patients with an active medical illness. For example, 59 of the 175 patients (34%) had active gastrointestinal disease; a total of 97 (55%) had a history of gastrointestinal disease, but the condition was not active in all patients.

Active musculoskeletal or joint disease was found in 56 patients (32%), and a total of 131 (75%) had a history of this comorbidity. A substantial fraction also had active genitourinary disease (43 patients, 25%), headaches or migraines (42 patients, 24%), asthma or respiratory disease (41 patients, 23%), and cardiovascular disease (32 patients, 18%). In addition, 58 patients (33%) were obese.

One analysis of the findings compared the efficacy of maintenance treatment in patients with four or more active comorbidities with those with fewer comorbidities. …

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