Susan L McElroy1, Scott Crow2, Thomas J Blom3, Alfredo B Cuellar-Barboza4, Miguel L Prieto5, Marin Veldic6, Stacey J Winham7, William V Bobo6, Jennifer Geske4, Lisa R Seymour6, Nicole Mori3, David J Bond8, Joanna M Biernacka9, Mark A Frye6. 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. Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico. 5. Universidad de los Andes, Facultad de Medicina, Departamento de Psiquiatría, Santiago, Chile. 6. Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA. 7. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA. 8. Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA. 9. Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Universidad de los Andes, Facultad de Medicina, Departamento de Psiquiatría, Santiago, Chile.
Abstract
OBJECTIVE: To determine whether bipolar spectrum disorder with binge eating behavior (BE) is an important clinical sub-phenotype. METHODS: Prevalence rates and correlates of different levels of BE were assessed in 1114 bipolar spectrum patients participating in a genetic biobank. BE and eating disorders (EDs) were assessed with the Eating Disorder Diagnostic Scale (EDDS). Psychiatric illness burden was evaluated with measures of suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. Medical illness burden was evaluated with body mass index (BMI) and the Cumulative Index Rating Scale (CIRS). RESULTS: Thirty percent of patients had any BE and 27% had BE plus an ED diagnosis. Compared with bipolar spectrum patients without BE, bipolar spectrum patients with BE were younger and more likely to be female; had significantly higher levels of eating psychopathology, suicidality, mood instability, and anxiety disorder comorbidity; had a significantly higher mean BMI and a significantly higher rate of obesity; and had a significantly higher medical illness burden. Bipolar spectrum patients with BE but no ED diagnosis were more similar to bipolar spectrum patients without BE than to those with an ED. Nonetheless, the positive predictive value and specificity of BE predicting an ED was 0.90 and 0.96, respectively. LIMITATIONS: As only two patients had co-occurring anorexia nervosa, these results may not generalize to bipolar spectrum patients with restricting EDs. CONCLUSION: Bipolar spectrum disorder with broadly-defined BE may not be as clinically relevant a sub-phenotype as bipolar spectrum disorder with an ED but may be an adequate proxy for the latter when phenotyping large samples of individuals.
OBJECTIVE: To determine whether bipolar spectrum disorder with binge eating behavior (BE) is an important clinical sub-phenotype. METHODS: Prevalence rates and correlates of different levels of BE were assessed in 1114 bipolar spectrum patients participating in a genetic biobank. BE and eating disorders (EDs) were assessed with the Eating Disorder Diagnostic Scale (EDDS). Psychiatric illness burden was evaluated with measures of suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. Medical illness burden was evaluated with body mass index (BMI) and the Cumulative Index Rating Scale (CIRS). RESULTS: Thirty percent of patients had any BE and 27% had BE plus an ED diagnosis. Compared with bipolar spectrum patients without BE, bipolar spectrum patients with BE were younger and more likely to be female; had significantly higher levels of eating psychopathology, suicidality, mood instability, and anxiety disorder comorbidity; had a significantly higher mean BMI and a significantly higher rate of obesity; and had a significantly higher medical illness burden. Bipolar spectrum patients with BE but no ED diagnosis were more similar to bipolar spectrum patients without BE than to those with an ED. Nonetheless, the positive predictive value and specificity of BE predicting an ED was 0.90 and 0.96, respectively. LIMITATIONS: As only two patients had co-occurring anorexia nervosa, these results may not generalize to bipolar spectrum patients with restricting EDs. CONCLUSION:Bipolar spectrum disorder with broadly-defined BE may not be as clinically relevant a sub-phenotype as bipolar spectrum disorder with an ED but may be an adequate proxy for the latter when phenotyping large samples of individuals.
Authors: William A Jons; Colin L Colby; Susan L McElroy; Mark A Frye; Joanna M Biernacka; Stacey J Winham Journal: Biol Sex Differ Date: 2019-12-09 Impact factor: 5.027
Authors: Susan L McElroy; Stacey J Winham; Alfredo B Cuellar-Barboza; Colin L Colby; Ada Man-Choi Ho; Hugues Sicotte; Beth R Larrabee; Scott Crow; Mark A Frye; Joanna M Biernacka Journal: Transl Psychiatry Date: 2018-02-02 Impact factor: 6.222