J Loftus1, J Scott2, F Vorspan3, R Icick3, C Henry4, S Gard5, J P Kahn6, M Leboyer7, F Bellivier8, B Etain9. 1. Centre Expert Trouble Bipolaire, Hospital Princesse Grace, Monaco; Fondation Fondamental, Créteil, France. 2. Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Université de Paris, Paris, France. 3. Université de Paris, Paris, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, Paris, France; Inserm UMRS 1144, Paris, France. 4. Fondation Fondamental, Créteil, France; Institut Pasteur, Unité Perception et Mémoire, Paris, France; Université Paris-Est-Créteil, Creteil, France; Département Médico-Universitaire Psychiatrie et Addictologie, DMU IMPACT, AP-HP, Hôpitaux Universitaires H. Mondor, Créteil, France. 5. Fondation Fondamental, Créteil, France; Hôpital Charles-Perrens, Centre Expert Trouble Bipolaire, Service de psychiatrie adulte, Pôle 3-4-7, Bordeaux, France. 6. Fondation Fondamental, Créteil, France; Université de Lorraine, CHRU de Nancy, Nancy, France and Fondation Santé des Etudiants de France (FSEF), Paris, France. 7. Fondation Fondamental, Créteil, France; Université Paris-Est-Créteil, Creteil, France; Département Médico-Universitaire Psychiatrie et Addictologie, DMU IMPACT, AP-HP, Hôpitaux Universitaires H. Mondor, Créteil, France; INSERM U955, Equipe 15 Psychiatrie Translationnelle, Creteil, France. 8. Fondation Fondamental, Créteil, France; Université de Paris, Paris, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, Paris, France; Inserm UMRS 1144, Paris, France. 9. Fondation Fondamental, Créteil, France; Université de Paris, Paris, France; AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, DMU Neurosciences, Paris, France; Inserm UMRS 1144, Paris, France. Electronic address: bruno.etain@inserm.fr.
Abstract
OBJECTIVES: Bipolar Disorder (BD) is frequently comorbid with other psychiatric disorders. However, few studies systematically examine which disorders are more likely to occur pre- or post-BD onset. We examine the prevalence and Age At Onset (AAO) of psychiatric conditions in adults with BD. METHODS: A structured clinical interview was used to assess lifetime history and AAO of alcohol and cannabis misuse, suicide attempts, anxiety and eating disorders in a French sample of euthymic patients with BD (n = 739). Regression analyses were used to test for statistically significant associations between rates and AAO of comorbidities in BD groups stratified by sex or subtype. RESULTS: Prevalence of alcohol and cannabis misuse was associated with male sex and BD-I subtype; whilst most anxiety and eating disorders were associated with female sex. The AAO of most comorbid conditions preceded that of BD, except for panic disorder, agoraphobia and alcohol misuse. Few variations were observed in AAO of comorbidities according to groups. LIMITATIONS: All assessments were retrospective, so estimates of prevalence rates and especially exact AAO of some comorbidities are at risk of recall bias. CONCLUSIONS: Sex and BD subtype are associated with different rates of comorbid disorders. However, there were minimal between group differences in median AAO of comorbidities. By describing the chronological sequence of comorbidities in BD we were able to demonstrate that a minority of comorbidities typically occurred post-onset of BD. This is noteworthy as these disorders might be amenable to interventions aimed at early secondary prevention.
OBJECTIVES:Bipolar Disorder (BD) is frequently comorbid with other psychiatric disorders. However, few studies systematically examine which disorders are more likely to occur pre- or post-BD onset. We examine the prevalence and Age At Onset (AAO) of psychiatric conditions in adults with BD. METHODS: A structured clinical interview was used to assess lifetime history and AAO of alcohol and cannabis misuse, suicide attempts, anxiety and eating disorders in a French sample of euthymic patients with BD (n = 739). Regression analyses were used to test for statistically significant associations between rates and AAO of comorbidities in BD groups stratified by sex or subtype. RESULTS: Prevalence of alcohol and cannabis misuse was associated with male sex and BD-I subtype; whilst most anxiety and eating disorders were associated with female sex. The AAO of most comorbid conditions preceded that of BD, except for panic disorder, agoraphobia and alcohol misuse. Few variations were observed in AAO of comorbidities according to groups. LIMITATIONS: All assessments were retrospective, so estimates of prevalence rates and especially exact AAO of some comorbidities are at risk of recall bias. CONCLUSIONS: Sex and BD subtype are associated with different rates of comorbid disorders. However, there were minimal between group differences in median AAO of comorbidities. By describing the chronological sequence of comorbidities in BD we were able to demonstrate that a minority of comorbidities typically occurred post-onset of BD. This is noteworthy as these disorders might be amenable to interventions aimed at early secondary prevention.
Authors: Romain Icick; Ingrid Melle; Bruno Etain; Margrethe Collier Høegh; Sébastien Gard; Sofie R Aminoff; Marion Leboyer; Ole A Andreassen; Raoul Belzeaux; Chantal Henry; Thomas D Bjella; Jean-Pierre Kahn; Nils Eiel Steen; Frank Bellivier; Trine Vik Lagerberg Journal: Front Psychiatry Date: 2022-05-03 Impact factor: 5.435
Authors: D Grillault Laroche; O Godin; Y Dansou; R Belzeaux; B Aouizerate; T Burté; P Courtet; C Dubertret; E Haffen; P M Llorca; E Olie; P Roux; M Polosan; R Schwan; M Leboyer; F Bellivier; C Marie-Claire; B Etain Journal: Eur Psychiatry Date: 2022-01-21 Impact factor: 5.361