Impulsivity, anxiety, and alcohol misuse in bipolar disorder comorbid with eating disorders

Jen, Andrew; Saunders, Erika F.H.; Ornstein, Rollyn M.; Kamali, Masoud; McInnis, Melvin G.

doi:10.1186/2194-7511-1-13

Cited by 29 publications

(30 citation statements)

References 58 publications

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“…Consistent with the findings of others, presence of a lifetime comorbid eating disorder in our study was associated with female gender, an earlier age at onset of bipolar disorder, and a history of rapid cycling and suicide, all of which predict a more severe course of illness (Brietzke et al, 2011; McElroy et al, 2011). While anxiety disorders often show comorbidity with bipolar disorder (McElroy et al, 2001), we find a dramatic increase in the comorbidity of panic disorder, OCD, and social phobia in bipolar patients with eating disorder comorbidity, consistent with prior observations (Jen et al, 2013). However, this may not be unexpected given the relationship between anxiety and eating disorders aside from the context of bipolar disorder (Kaye, 2008).…”

Section: Discussionsupporting

confidence: 91%

“…However, this may not be unexpected given the relationship between anxiety and eating disorders aside from the context of bipolar disorder (Kaye, 2008). Finally, childhood trauma has been implicated as a precursor to both bipolar disorder and eating disorders, with a particular emphasis on physical abuse as a trigger (Jen et al, 2013; Leverich et al, 2002; Post and Leverich, 2006; Rayworth et al, 2004; Rodriguez et al, 2005). Our data provides further evidence to support this connection, with an increased incidence of traumatic events in childhood for bipolar patients with eating disorder comorbidity, an effect that seems to be driven primarily by experiences of physical abuse and violence.…”

Section: Discussionmentioning

confidence: 99%

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A genome-wide association study of bipolar disorder with comorbid eating disorder replicates the SOX2-OT region

Study

2016

Journal of Affective Disorders

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Background Bipolar disorder is a heterogeneous mood disorder associated with several important clinical comorbidities, such as eating disorders. This clinical heterogeneity complicates the identification of genetic variants contributing to bipolar susceptibility. Here we investigate comorbidity of eating disorders as a subphenotype of bipolar disorder to identify genetic variation that is common and unique to both disorders. Methods We performed a genome-wide association analysis contrasting 184 bipolar subjects with eating disorder comorbidity against both 1,370 controls and 2,006 subjects with bipolar disorder only from the Bipolar Genome Study (BiGS). Results The most significant genome-wide finding was observed bipolar with comorbid eating disorder vs. controls within SOX2-OT (p=8.9×10−8 for rs4854912) with a secondary peak in the adjacent FXR1 gene (p=1.2×10−6 for rs1805576) on chromosome 3q26.33. This region was also the most prominent finding in the case-only analysis (p=3.5×10−7 and 4.3×10−6, respectively). Several regions of interest containing genes involved in neurodevelopment and neuroprotection processes were also identified. Limitations While our primary finding did not quite reach genome-wide significance, likely due to the relatively limited sample size, these results can be viewed as a replication of a recent study of eating disorders in a large cohort. Conclusions These findings replicate the prior association of SOX2-OT with eating disorders and broadly support the involvement of neurodevelopmental/neuroprotective mechanisms in the pathophysiology of both disorders. They further suggest that different clinical manifestations of bipolar disorder may reflect differential genetic contributions and argue for the utility of clinical subphenotypes in identifying additional molecular pathways leading to illness.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

A genome-wide association study of bipolar disorder with comorbid eating disorder replicates the SOX2-OT region

Study

2016

Journal of Affective Disorders

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“…To our knowledge, outside of Johns Hopkins and the University of Michigan Prechter Bipolar Genetics Repository, and the Psychiatric Genomics Consortium there are few bipolar disease biobanks actively recruiting with simultaneous recruitment of healthy controls in the public domain . Although there may be bipolar biospecimen repositories associated with clinical drug development and industry‐sponsored clinical trials in bipolar disorder, they have not focused on disease risk candidate genes or genome‐wide association studies.…”

Section: Discussionmentioning

confidence: 99%

National Survey and Community Advisory Board Development for a Bipolar Disorder Biobank

Frye

Doederlein²,

Koenig

et al. 2015

Bipolar Disorders

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Objectives To engage a national advocacy group and local stakeholders for guidance in developing a bipolar disorder biobank through a web-based survey and a community advisory board. Methods The Depression and Bipolar Support Alliance and the Mayo Clinic Bipolar Biobank conducted a national web-based survey inquiring about interest in participating in a biobank (i.e., giving DNA and clinical information). A community advisory board was convened to guide establishment of the biobank and identify key deliverables from the research project and for the community. Results Among 385 survey respondents, funding source (87%), professional opinion (76%), mental health consumer opinion (79%), and return of research results (91%) were believed to be important for considering study participation. Significantly more patients were willing to participate in a biobank managed by a university or clinic (78.2%) than one managed by government (63.4%) or industry (58.2%; both p < 0.001). The nine-member community advisory board expressed interest in research to help predict the likelihood of bipolar disorder developing in a child of an affected parent and which medications to avoid. The advisory board endorsed the use of a comprehension questionnaire to evaluate participants' understanding of the study (e.g., longevity of DNA specimens, right to remove samples, accessing medical records) as a means to strengthen the informed-consent process. Conclusions These national survey and community advisory data support the merit of establishing a biobank to enable studies of disease risk, provided that health records and research results are adequately protected. The goals of earlier diagnosis and individualized treatment of bipolar disorder were endorsed.

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“…Comorbid eating disorders, which are particularly associated with the depressive phases of bipolar disorder 72 , have a much higher prevalence for patients with bipolar disorder (range, 6-27%) than for individuals in the general population (4-10%) 73,74 . Binge eating behavior is an important consideration for clinicians since it may serve as an early predictor of eating disorders in patients with bipolar spectrum disorder 75 .…”

Section: Psychiatric Comorbiditiesmentioning

confidence: 99%

Bipolar depression: the clinical characteristics and unmet needs of a complex disorder

McIntyre

Calabrese

2019

Current Medical Research and Opinion

111

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Objective: We reviewed important clinical aspects of bipolar depression, a progressive psychiatric condition that is commonly treated in primary care. Bipolar depression is associated with considerable burden of illness, high suicide risk, and greater morbidity and mortality than bipolar mania. Methods: We identified articles relevant to our narrative review using a multistep search of the literature and applying terms that were relevant to bipolar depression or bipolar disorder. Results: Bipolar depression accounts for the majority of time spent unwell for patients with bipolar disorder; high rates of morbidity and mortality arise from full symptomatic episodes and interepisode subsyndromal symptoms. Bipolar depression is an important contributor to long-term dysfunction for patients with bipolar disorder due to psychosocial impairment, loss of work productivity and high rates of substance abuse. Missed and delayed diagnosis is prevalent due to overlapping symptoms with unipolar depression and other diagnoses. Medical comorbidities (i.e. cardiovascular disease, hypertension, obesity, metabolic syndrome) and psychiatric comorbidities (i.e. anxiety disorder, personality disorder, eating disorder, attention-deficit/hyperactivity disorder) are common. Currently, only three treatments are FDA-approved for bipolar depression; monotherapy antidepressants are not a recommended treatment option. Conclusions: Bipolar disorder is common among primary care patients presenting with depression; it is often treated exclusively in primary care. Clinicians should be alert for symptoms of bipolar disorder in undiagnosed patients, know what symptoms probabilistically suggest bipolar versus unipolar depression, have expertise in providing ongoing treatment to diagnosed patients, and be knowledgeable about managing common medication-related side effects and comorbidities. Prompt and accurate diagnosis is critical. ARTICLE HISTORY

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Impulsivity, anxiety, and alcohol misuse in bipolar disorder comorbid with eating disorders

Cited by 29 publications

References 58 publications

A genome-wide association study of bipolar disorder with comorbid eating disorder replicates the SOX2-OT region

A genome-wide association study of bipolar disorder with comorbid eating disorder replicates the SOX2-OT region

National Survey and Community Advisory Board Development for a Bipolar Disorder Biobank

Bipolar depression: the clinical characteristics and unmet needs of a complex disorder

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