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General medical burden in bipolar disorder: findings from the Li TMUS comparative effectiveness trial
Author(s) -
Kemp D. E.,
Sylvia L. G.,
Calabrese J. R.,
Nierenberg A. A.,
Thase M. E.,
ReillyHarrington N. A.,
Ostacher M. J.,
Leon A. C.,
Ketter T. A.,
Friedman E. S.,
Bowden C. L.,
Rabideau D. J.,
Pencina M.,
Iosifescu D. V.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12101
Subject(s) - comorbidity , bipolar disorder , medicine , overweight , body mass index , mood , psychiatry , randomized controlled trial , major depressive disorder , rating scale , psychology , developmental psychology
Objective This study examined general medical illnesses and their association with clinical features of bipolar disorder. Method Data were cross‐sectional and derived from the Lithium Treatment – Moderate Dose Use Study (Li TMUS ), which randomized symptomatic adults ( n = 264 with available medical comorbidity scores) with bipolar disorder to moderate doses of lithium plus optimized treatment ( OPT ) or to OPT alone. Clinically significant high and low medical comorbidity burden were defined as a Cumulative Illness Rating Scale ( CIRS ) score ≥4 and <4 respectively. Results The baseline prevalence of significant medical comorbidity was 53% ( n = 139). Patients with high medical burden were more likely to present in a major depressive episode ( P = .04), meet criteria for obsessive–compulsive disorder ( P = .02), and experience a greater number of lifetime mood episodes ( P = 0.02). They were also more likely to be prescribed a greater number of psychotropic medications ( P = .002). Sixty‐nine per cent of the sample was overweight or obese as defined by body mass index ( BMI ), with African Americans representing the racial group with the highest proportion of stage II obesity ( BMI ≥35; 31%, n = 14). Conclusion The burden of comorbid medical illnesses was high in this generalizable sample of treatment‐seeking patients and appears associated with worsened course of illness and psychotropic medication patterns.