Objective-Overweight/obesity, insulin resistance (IR), and other types of metabolic dysfunction are common in patients with bipolar disorder (BD); however, the pathophysiological underpinnings of metabolic dysfunction in BD are not fully understood. Family history of type 2 diabetes mellitus (FamHxDM2), which has been shown to have deleterious effects on metabolic function in the general population, may play a role in the metabolic dysfunction observed in BD.Methods-Using multivariate analysis of variance, the effects of BD illness and/or FamHxDM2 were examined relative to metabolic biomarkers in 103 women with BD and 36 healthy, agematched control women.Results-As a group, women with BD had higher levels of fasting plasma insulin (FPI) and fasting plasma glucose (FPG), higher homeostatic assessment of IR (HOMA-IR) scores, body mass index (BMI), waist circumference (WC), and hip circumference (HC) compared to control women. FamHxDM2 was associated with significantly worse metabolic biomarkers among women with BD but not among healthy control women. Among women with BD, there was a significant main effect of FamHxDM2 on FPI, HOMA-IR, BMI, WC, and HC, even after controlling for type of BD illness, duration of medication exposure, and depression severity. Metabolic biomarkers were not influenced by use of weight-liable psychotropic medication (WLM), even after controlling for type of BD illness, duration of medication exposure, and depression severity.Conclusions-Women with BD have overall worse metabolic biomarkers than age-matched control women. The use of WLM, duration of medication use, type of BD illness, and depression severity did not appear to be associated with more pronounced metabolic dysfunction. FamHxDM2 may represent a risk factor for the development of IR in women with BD. Further, focused studies of the endocrine profiles of families of BD patients are needed. Over the last decade, metabolic dysfunction [i.e., overweight/obesity, insulin resistance (IR), and dyslipidemia] has become increasingly important in clinical medicine in general and in psychiatry in particular (1,2). Despite intense scientific focus on this topic, risk factors for developing metabolic dysfunction as well as its pathophysiology among patients with mental illness remain to be elucidated. KeywordsIR is recognized as central to the pathophysiology of many metabolic abnormalities and is a known precursor condition for type 2 diabetes mellitus (DM2), obesity, cardiovascular illness (3), and neurocognitive disorders (4). With respect to its prevalence in mood disorders, IR is hypothesized to be (i) an underlying state predisposing toward both mood disorders and metabolic disorders, (ii) a side effect of the psychotropic medications used to treat mood disorders, and/or (iii) a consequence of mood disorders themselves (e.g., lifestyle changes or stress). While our group and others have previously reported high rates of overweight/obesity and surrogate biomarkers of IR in samples of women with bipolar disorder (BD) (5-9), ther...

Objectives The purpose of this study was to investigate the reproductive function of women with bipolar disorder (BD) compared to healthy controls. Methods Women diagnosed with BD and healthy controls with no psychiatric history ages 18 to 45 years were recruited from a university clinic and surrounding community. Participants completed a baseline reproductive health questionnaire, serum hormone assessment, and ovulation tracking for three consecutive cycles using urine luteinizing hormone (LH)-detecting strips with a confirmatory luteal-phase serum progesterone. Results Women with BD (n = 103) did not differ from controls (n = 36) in demographics, rates of menstrual abnormalities (MA), or number of ovulation-positive cycles. Of the women with BD, 17% reported a current MA and 39% reported a past MA. Dehydroepiandrosterone sulfate and 17-hydroxyprogresterone were higher in controls (p = 0.052 and 0.004, respectively), otherwise there were no differences in biochemical levels. Medication type, dose, or duration was not associated with MA or biochemical markers, except those currently taking an atypical antipsychotic indicated a greater rate of current or past MA (80% versus 55%, p = 0.013). In women with BD, 22% reported a period of amenorrhea associated with exercising or stress, versus 8% of controls (p = 0.064). Self-reported rates of bulimia and anorexia nervosa were 10% and 5%, respectively. Conclusions Rates of MA and biochemical levels did not significantly differ between women with BD and controls. Current atypical antipsychotic use was associated with a higher rate of current or past MA and should be further investigated. Incidence of stress-induced amenorrhea should be further investigated in this population, as should comorbid incidence of eating disorders.

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The present study examined the interaction of emotional activation and self-regulation in elite collegiate athletes. We hypothesized that athletes would report higher levels of self-restraint, repressive defensiveness and denial of distress, but lower levels of distress than non-athletes. Participants were composed of 461 collegiate athletes and 61 age-and gender-matched non-athletes from Stanford University. Social-emotional adjustment and personality were assessed with the Weinberger Adjustment Inventory. Results indicate significant differences between athletes and non-athletes. Athletes report lower levels of distress, higher levels of self-restraint, repressive defensiveness and denial of distress. Logistic regressions assessed the important predictors of athlete status. Age, denial of distress and responsibility proved to be the most signifi cant indicators of athlete status. Data can be interpreted in at least two ways: (1) athletes are better at dealing with pressure and therefore report lower levels of distress; or (2) athletes report lower distress because they utilize high levels of repressive defensiveness and denial of distress. Utilizing non self-report methods would further clarify this question and would provide a deeper understanding of personality traits in athletes.