Obesity as a Correlate of Outcome in Patients With Bipolar I Disorder

Fagiolini, Andrea; Kupfer, David J.; Houck, Patricia R.; Novick, Danielle M.; Frank, Ellen

doi:10.1176/appi.ajp.160.1.112

Cited by 365 publications

(280 citation statements)

References 23 publications

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“…In our sample, DSM-IV Axis III comorbidity was more prevalent amongst the most recurrent patients; in agreement with previous studies (Fagiolini et al 2002, Fagiolini et al 2003, it is possible to consider this finding as another risk factor of poorer functioning outcome amongst the bipolar patients.…”

Section: Discussionsupporting

confidence: 92%

The impact of the number of episodes on the outcome of Bipolar Disorder

et al. 2006

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-Background: Bipolar disorder is a highly recurrent severe psychiatric disorder. The number of episodes has been found consistently associated with poor outcome. It has been suggested that bipolar patients with long duration of illness and highly recurrent course show great impairment of global functioning.Objectives: The aim of this study is to assess the clinical course and outcome of patients with bipolar disorder I and II with a high number of mood episodes.Methods: We compared a group of bipolar I and II subjects whose number of episode was higher than ten (N = 167) with a similar-size representative sample of bipolar patients whose number of episodes was lower or equal than ten (N = 131).Results: Bipolar patients with more than 10 episodes have a more severe outcome of bipolar disorder. Qualification and occupational status was clearly worse for the highly recurrent group which showed a predominance of depressive polarity.Conclusions: These data suggest that bipolar patients with a highly recurrent course have significant functional impairment. With the passing of time, bipolar illness tends to be ruled by depressive features. Treatment strategies may need to address this issue.

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Section: Discussionsupporting

confidence: 92%

The impact of the number of episodes on the outcome of Bipolar Disorder

et al. 2006

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“…Elevated rates of additional psychiatric comorbidity in patients with 2 versus 1 presenting disorder have been documented in a number of psychiatric populations (e.g., 20,21). Nevertheless, given that both obesity and anxiety comorbidity have been shown to correlate with indicators of poor prognosis in bipolar patients (e.g., delayed response to treatment, shorter time to recurrence) (22,23), future studies are needed to determine the impact of aberrant eating on the clinical course of bipolar disorder and its treatment. In addition, research to tease apart the temporal and pathophysiological relationships among eating disorder symptoms, obesity, mood disorder history, and other psychiatric co-morbidity seems warranted.…”

Section: Discussionmentioning

confidence: 99%

Eating disorders and illness burden in patients with bipolar spectrum disorders

Wildes

Marcus

Fagiolini

2007

Comprehensive Psychiatry

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Objectives-To evaluate the clinical significance of lifetime eating disorder co-morbidity in a welldefined sample of patients with bipolar spectrum disorders and to describe cognitive correlates of disordered eating in this group.Method-Twenty-six bipolar patients with a lifetime history of a DSM-IV defined eating disorder (n = 17) or a clinically significant subthreshold eating disorder (n = 9) (ED group) were compared to 46 bipolar patients with no history of an eating disorder (No ED group) on demographic and clinical characteristics at study presentation, history of bipolar illness, and other psychiatric co-morbidity. Measures included the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Clinical Global Impression-Severity Scale-Bipolar Version (CGI-S-BP), and the Eating Disorder Examination (EDE). Height and weight were recorded to calculate body mass index (BMI).Results-Patients in the ED group were heavier and were rated as more symptomatic on the CGI-S-BP than were patients in the No ED group. The ED group also had a higher number of lifetime depressive episodes and greater psychiatric co-morbidity, excluding eating and mood disorders. Finally, after controlling for BMI and CGI-S-BP rating, patients in the ED group had significantly higher EDE Restraint, Eating Concern, Shape Concern, Weight Concern, and Global scores than did patients in the No ED group.Conclusions-These findings highlight the need for a renewed emphasis on the evaluation and management of weight and eating in the mood disorders. In particular, this research suggests that eating disorder co-morbidity may be a marker for increased symptom load and illness burden in bipolar disorder.

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“…The serum levels of glucocorticoids and melatonin, factors with potent adipogenic properties, exhibit circadian oscillations (Hirota and Fukada 2004;Lowrey and Takahashi 2004). Eating during periods of darkness (Holmback et al 2002(Holmback et al , 2003Spiegel et al 2004) and antipsychotic drugs influencing circadian rhythms such as lithium chloride and valproic acid (Baptista et al 1995;Elmslie et al 2001;Atmaca et al 2002;Chengappa et al 2002;Fagiolini et al 2002Fagiolini et al , 2003Iwahana et al 2004) have been associated with an increased incidence of obesity. The serum levels of multiple adipose-derived proteins, including adiponectin, interleukin-6, leptin, lipoprotein lipase, PAI-1, and tumor necrosis factor-α, display a diurnal profile characterized by a distinct amplitude, zenith (peak), and nadir (trough) (Kotlar and Borensztajn 1977;Goubern and Portet 1981;Saad et al 1998;Ahmad et al 2001;Arasaradnam et al 2002;Mastronardi et al 2002;Gavrila et al 2003;Calvani et al 2004;Ruge et al 2004;Yildiz et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Biological aging alters circadian mechanisms in murine adipose tissue depots

Sutton

Ptitsyn

Floyd

et al. 2012

AGE

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Biological aging alters the metabolism and volume of adipose tissue depots. Recent evidence suggests that circadian mechanisms play a role in promoting adipogenesis, obesity, and lipodystrophy.The current study compared cohorts of younger (5-9 months) and older (24-28 months) C57BL/6 mice as a function of biological age and circadian time. Advanced age significantly reduced the weight of the AGE (2013) 35:533-547 DOI 10.1007 Electronic supplementary material The online version of this article (doi:10.1007/s11357-012-9389-7) contains supplementary material, which is available to authorized users. brown, epididymal, inguinal, and retroperitoneal adipose depots but not total body weight. The older mice reduced their physical activity by >50% and delayed their activity initiation after light offset. The expressed transcriptome in brown and white adipose depots and liver of both cohorts displayed evidence of circadian rhythmicity; however, the oscillating mRNAs differed significantly between age groups and across tissues. The amplitude of Cry1, a component of the negative arm of the circadian apparatus, and downstream regulators such as Rev-erbα were elevated in the older relative to the younger cohorts as a function of circadian time. Overall, transcript levels differed significantly for 557 (inguinal adipose), 1,016 (liver), and 1,021 (brown adipose) expressed sequences between the cohorts as a function of age. These included transcripts encoding proteins within the canonical and non-canonical Wnt pathways. Since the Wnt pathway regulates adipose stem cell differentiation and shares a critical enzyme, glycogen synthase kinase 3β, with the circadian mechanism, the intersection between these two fundamental regulatory mechanisms merits further investigation with respect to biological aging of adipose tissues.

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Obesity as a Correlate of Outcome in Patients With Bipolar I Disorder

Cited by 365 publications

References 23 publications

The impact of the number of episodes on the outcome of Bipolar Disorder

The impact of the number of episodes on the outcome of Bipolar Disorder

Eating disorders and illness burden in patients with bipolar spectrum disorders

Biological aging alters circadian mechanisms in murine adipose tissue depots

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