Susan L McElroy1, Scott Crow2, Thomas J Blom3, Joanna M Biernacka4, Stacey J Winham5, Jennifer Geske5, Alfredo B Cuellar-Barboza6, William V Bobo7, Miguel L Prieto8, Marin Veldic7, Nicole Mori3, Lisa R Seymour7, David J Bond9, Mark A Frye7. 1. Lindner Center of HOPE, 4075 Old Western Row Road, Mason, OH 45040, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Electronic address: susan.mcelroy@lindnercenter.org. 2. Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA; The Emily Program, St. Paul, MN, USA. 3. Lindner Center of HOPE, 4075 Old Western Row Road, Mason, OH 45040, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 4. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA; Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA. 5. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA. 6. Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico. 7. Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA. 8. Universidad de los Andes, Facultad de Medicina, Departamento de Psiquiatría, Santiago, Chile. 9. Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.
Abstract
OBJECTIVE: To determine prevalence rates and clinical correlates of current DSM-5 eating disorders in patients with bipolar disorder (BP). METHODS: Prevalence rates of current DSM-5- and DSM-IV-defined binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) were assessed with the Eating Disorder Diagnostic Scale (EDDS) in 1092 patients with BP. Psychiatric illness burden was evaluated with five proxy measures of BP illness severity. Medical illness burden was evaluated with the Cumulative Index Rating Scale (CIRS). RESULTS: Twenty-seven percent of patients had a current DSM-5 eating disorder: 12% had BED, 15% had BN, and 0.2% had AN. Rates of DSM-5-defined BED and BN were higher than clinical diagnosis rates and rates of DSM-IV-defined BED and BN. Compared with BP patients without an eating disorder, BP patients with a DSM-5 eating disorder were younger and more likely to be women; had an earlier age of onset of BP; had higher EDDS composite scores and higher degrees of suicidality, mood instability, and anxiety disorder comorbidity; and had a higher mean BMI, higher rate of obesity, and higher CIRS total scores. In a logistic regression model controlling for previously identified correlates of an eating disorder, younger age, female gender, and higher BMI remained significantly associated with an eating disorder. LIMITATIONS: The EDDS has not been validated in BP patients. CONCLUSION: DSM-5-defined BED and BN are common in BP patients, possibly more common than DSM-IV-defined BED and BN, and associated with greater psychiatric and general medical illness burden. Further studies assessing DSM-5 eating disorders in people with BP are greatly needed.
OBJECTIVE: To determine prevalence rates and clinical correlates of current DSM-5 eating disorders in patients with bipolar disorder (BP). METHODS: Prevalence rates of current DSM-5- and DSM-IV-defined binge eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) were assessed with the Eating Disorder Diagnostic Scale (EDDS) in 1092 patients with BP. Psychiatric illness burden was evaluated with five proxy measures of BP illness severity. Medical illness burden was evaluated with the Cumulative Index Rating Scale (CIRS). RESULTS: Twenty-seven percent of patients had a current DSM-5 eating disorder: 12% had BED, 15% had BN, and 0.2% had AN. Rates of DSM-5-defined BED and BN were higher than clinical diagnosis rates and rates of DSM-IV-defined BED and BN. Compared with BP patients without an eating disorder, BP patients with a DSM-5 eating disorder were younger and more likely to be women; had an earlier age of onset of BP; had higher EDDS composite scores and higher degrees of suicidality, mood instability, and anxiety disorder comorbidity; and had a higher mean BMI, higher rate of obesity, and higher CIRS total scores. In a logistic regression model controlling for previously identified correlates of an eating disorder, younger age, female gender, and higher BMI remained significantly associated with an eating disorder. LIMITATIONS: The EDDS has not been validated in BP patients. CONCLUSION: DSM-5-defined BED and BN are common in BP patients, possibly more common than DSM-IV-defined BED and BN, and associated with greater psychiatric and general medical illness burden. Further studies assessing DSM-5 eating disorders in people with BP are greatly needed.
Authors: Diana Khoubaeva; Mikaela Dimick; Vanessa H Timmins; Lisa M Fiksenbaum; Rachel H B Mitchell; Ayal Schaffer; Mark Sinyor; Benjamin I Goldstein Journal: Eur Child Adolesc Psychiatry Date: 2021-05-24 Impact factor: 4.785
Authors: Danielle R Balzafiore; Natalie L Rasgon; Laura D Yuen; Saloni Shah; Hyun Kim; Kathryn C Goffin; Shefali Miller; Po W Wang; Terence A Ketter Journal: Int J Bipolar Disord Date: 2017-08-12
Authors: Julia Martini; Karolina Leopold; Steffi Pfeiffer; Christina Berndt; Anne Boehme; Veit Roessner; Paolo Fusar-Poli; Allan H Young; Christoph U Correll; Michael Bauer; Andrea Pfennig Journal: Int J Bipolar Disord Date: 2021-07-02