Leslie Radon1,2, C B K Lam3, A Letranchant3, F Hirot4, S Guillaume5, N Godart4,6,7,8. 1. Département de Psychiatrie Et D'Addictologie, Unité TCA, 94800, Villejuif, France. leslie.radon@aphp.fr. 2. Department of Psychiatry of Adolescent and Young Adult, Institut Mutualiste Montsouris, Paris, France. leslie.radon@aphp.fr. 3. Department of Psychiatry of Adolescent and Young Adult, Institut Mutualiste Montsouris, Paris, France. 4. Fondation Santé Des Etudiants de France, Paris, France. 5. Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, 34090, Montpellier, France. 6. INSERM U 1178, CESP, Univ. Paris-Sud, UVSQ, University Paris-Saclay, 94805, Villejuif, France. 7. UFR of Sciences of Health Simone Veil, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France. 8. University of Medicine Paris Descartes, Paris, France.
Abstract
BACKGROUND: The comorbidity between anorexia nervosa (AN) and bipolar disorders (BD) among subjects with AN is a matter of some debate, regarding its existence, its impact on the clinical manifestations of AN and the nature of the relationship between these disorders. Our aims were: (1) to evaluate the prevalence of BD among patients with severe AN; and (2) to determine whether people with a history of BD present particular clinical AN characteristics in comparison to people with a comorbid major depressive disorder or with any mood disorder comorbidity. METHODS: 177 AN subjects were surveyed to assess their nutritional state, dietary symptomatology, psychiatric comorbidities, treatments received and associated response. The diagnosis of BD relied on DSM-5 criteria, using the short-CIDI. The discriminant features of patients with AN and suspected BD were identified, comparing them to the characteristics of AN patients without any mood disorder and AN patients suffering from major depressive disorder. RESULTS: Among AN subjects, 11.3% were suspected to have BD. In comparison with the two other groups, these patients had more severe clinical profiles in terms of duration of AN (6.7 years, p = 0.020), nutritional state (p max = 0.031), levels of anxious, depressive and dietary symptoms, lifetime comorbidity with anxious disorders, quality-of-life (p = 0.001) and treatment (antidepressant and mood stabilizers, (p = 0.029)). LIMITATIONS: The participants were hospitalized in a tertiary center with severe AN. The diagnosis of BD requires evaluation using a more precise diagnostic instrument CONCLUSION: These results underline the importance of systematic early detection of BD and mood disorders among individuals with severe AN, to provide optimum treatment. LEVEL OF EVIDENCE: III: Evidence obtained from a cross-sectional study.
BACKGROUND: The comorbidity between anorexia nervosa (AN) and bipolar disorders (BD) among subjects with AN is a matter of some debate, regarding its existence, its impact on the clinical manifestations of AN and the nature of the relationship between these disorders. Our aims were: (1) to evaluate the prevalence of BD among patients with severe AN; and (2) to determine whether people with a history of BD present particular clinical AN characteristics in comparison to people with a comorbid major depressive disorder or with any mood disorder comorbidity. METHODS: 177 AN subjects were surveyed to assess their nutritional state, dietary symptomatology, psychiatric comorbidities, treatments received and associated response. The diagnosis of BD relied on DSM-5 criteria, using the short-CIDI. The discriminant features of patients with AN and suspected BD were identified, comparing them to the characteristics of AN patients without any mood disorder and AN patients suffering from major depressive disorder. RESULTS: Among AN subjects, 11.3% were suspected to have BD. In comparison with the two other groups, these patients had more severe clinical profiles in terms of duration of AN (6.7 years, p = 0.020), nutritional state (p max = 0.031), levels of anxious, depressive and dietary symptoms, lifetime comorbidity with anxious disorders, quality-of-life (p = 0.001) and treatment (antidepressant and mood stabilizers, (p = 0.029)). LIMITATIONS: The participants were hospitalized in a tertiary center with severe AN. The diagnosis of BD requires evaluation using a more precise diagnostic instrument CONCLUSION: These results underline the importance of systematic early detection of BD and mood disorders among individuals with severe AN, to provide optimum treatment. LEVEL OF EVIDENCE: III: Evidence obtained from a cross-sectional study.
Authors: Susan L McElroy; Mark A Frye; Gerhard Hellemann; Lori Altshuler; Gabriele S Leverich; Trisha Suppes; Paul E Keck; Willem A Nolen; Ralph Kupka; Robert M Post Journal: J Affect Disord Date: 2010-07-31 Impact factor: 4.839
Authors: Kathleen R Merikangas; Robert Jin; Jian-Ping He; Ronald C Kessler; Sing Lee; Nancy A Sampson; Maria Carmen Viana; Laura Helena Andrade; Chiyi Hu; Elie G Karam; Maria Ladea; Maria Elena Medina-Mora; Yutaka Ono; Jose Posada-Villa; Rajesh Sagar; J Elisabeth Wells; Zahari Zarkov Journal: Arch Gen Psychiatry Date: 2011-03