Hortense Boulanger1, Sarah Tebeka2, Chloé Girod3, Célia Lloret-Linares4, Julie Meheust5, Jan Scott6, Sébastien Guillaume7, Philippe Courtet7, Frank Bellivier8, Marine Delavest9. 1. AP-HP, GH Saint-Louis, Lariboisière, Fernand Widal, Departement de Psychiatrie et de Médecine Addictologique, Paris, France; Centre Hospitalier Sainte-Anne, 3ème Secteur de Psychiatrie Adulte, Paris, France. 2. AP-HP, GH Saint-Louis, Lariboisière, Fernand Widal, Departement de Psychiatrie et de Médecine Addictologique, Paris, France; AP-HP, Louis Mourier, Department of Psychiatry, Colombes, France / Centre for Psychiatry and Neurosciences, Inserm U894, Paris, France. 3. Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier / INSERM U1061, University of Montpellier, Montpellier, France. 4. AP-HP, GH Saint-Louis, Lariboisière, Fernand Widal, Therapeutic Research Unit, Department of Internal Medicine, Paris, France; Inserm, UMR-S 1144, Université Paris Descartes- Paris Diderot, Paris, France. 5. AP-HP, GH Saint-Louis, Lariboisière, Fernand Widal, Departement de Psychiatrie et de Médecine Addictologique, Paris, France. 6. Department of Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK / Centre for Affective Disorders, Department of Psychological Medicine, IPPN, Kings College, London, UK. 7. Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier / INSERM U1061, University of Montpellier, Montpellier, France; Fondation FondaMental, Créteil, France. 8. AP-HP, GH Saint-Louis, Lariboisière, Fernand Widal, Departement de Psychiatrie et de Médecine Addictologique, Paris, France; Inserm, UMR-S 1144, Université Paris Descartes- Paris Diderot, Paris, France; Fondation FondaMental, Créteil, France. Electronic address: frank.bellivier@inserm.fr. 9. AP-HP, GH Saint-Louis, Lariboisière, Fernand Widal, Departement de Psychiatrie et de Médecine Addictologique, Paris, France; Inserm, UMR-S 1144, Université Paris Descartes- Paris Diderot, Paris, France; Fondation FondaMental, Créteil, France.
Abstract
BACKGROUND: Recent research, especially from the USA, suggests that comorbid binge eating (BE) behaviour and BE disorder are frequent in individuals with Bipolar Disorder (BD). Although basic clinical associations between BD and BE have been investigated, less is known about psychological or temperamental dimensions and qualitative aspects of eating habits. In a French cohort of patients with BD, we investigated the prevalence of BE behaviour and any associations with illness characteristics, anxiety, impulsivity, emotional regulation and eating habits. METHODS: 145 outpatients with BD (I and II) were assessed for the presence of BE behaviour using the Binge Eating Scale (BES). Characteristics identified in univariate analyses as differentiating BD cases with and without BE behaviour were then included in a backward stepwise logistic regression (BSLR) model. RESULTS: In this sample, 18.6% of BD patients met criteria for BE behaviour. Multivariate analysis (BSLR) indicated that shorter duration of BD, and higher levels of anxiety and emotional reactivity were observed in BD with compared to BD without BE behaviour. LIMITATIONS: Relatively small sample referred to specialist BD clinics and cross-sectional evaluation meant that it was not possible to differentiate between state and trait levels of impulsivity, emotional instability and disinhibition. These dimensions may also overlap with mood symptoms. CONCLUSION: BE behaviour is common in females and males with BD. Emotional dysregulation and anxiety may represent important shared vulnerability factors for worse outcome of BD and increased likelihood of BE behaviour.
BACKGROUND: Recent research, especially from the USA, suggests that comorbid binge eating (BE) behaviour and BE disorder are frequent in individuals with Bipolar Disorder (BD). Although basic clinical associations between BD and BE have been investigated, less is known about psychological or temperamental dimensions and qualitative aspects of eating habits. In a French cohort of patients with BD, we investigated the prevalence of BE behaviour and any associations with illness characteristics, anxiety, impulsivity, emotional regulation and eating habits. METHODS: 145 outpatients with BD (I and II) were assessed for the presence of BE behaviour using the Binge Eating Scale (BES). Characteristics identified in univariate analyses as differentiating BD cases with and without BE behaviour were then included in a backward stepwise logistic regression (BSLR) model. RESULTS: In this sample, 18.6% of BD patients met criteria for BE behaviour. Multivariate analysis (BSLR) indicated that shorter duration of BD, and higher levels of anxiety and emotional reactivity were observed in BD with compared to BD without BE behaviour. LIMITATIONS: Relatively small sample referred to specialist BD clinics and cross-sectional evaluation meant that it was not possible to differentiate between state and trait levels of impulsivity, emotional instability and disinhibition. These dimensions may also overlap with mood symptoms. CONCLUSION: BE behaviour is common in females and males with BD. Emotional dysregulation and anxiety may represent important shared vulnerability factors for worse outcome of BD and increased likelihood of BE behaviour.