Physical health of patients with bipolar disorder

Young, Allan H.; Oldani, Lucio

doi:10.1111/appy.12081

Cited by 16 publications

(24 citation statements)

References 9 publications

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“…Baseline approvals were granted by each assessment site. Written parental approval and verbal approval were obtained for patients in the [15][16][17] year age range at study entry. Inclusion criteria at study entry were age 15-60 years, residence in Suffolk County, NY, and psychosis; exclusion criteria were psychiatric hospitalization more than 6 months before the index admission, more than moderate mental retardation (now intellectual disability), and non-English speaking.…”

Section: Methodsmentioning

confidence: 99%

“…4 Individuals with schizophrenia (SCZ) and those with bipolar disorder (BP) have an increased prevalence of obesity and related comorbidities compared to the general population, 5 although they are slightly less common and severe in people with BP compared to SCZ. [6][7][8] Individuals with both diagnoses are at increased risk of metabolic comorbidities, [9][10][11][12] including dyslipidemia, insulin resistance and hyperglycemia, 13,14 as well as cardiovascular disease, diabetes, hypertension 15 and metabolic syndrome. 16 The lifespan is 20 years shorter on average for SCZ and 10 years shorter for BP compared to population norms.…”

Section: Introductionmentioning

confidence: 99%

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Twenty‐year progression of body mass index in a county‐wide cohort of people with schizophrenia and bipolar disorder identified at their first episode of psychosis

et al. 2017

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Objective There is increased prevalence of obesity in schizophrenia and bipolar disorder, leading to disproportionate risk of adverse health conditions. Prospective, long-term weight gain data, however, are scarce. Methods We analyzed data from the Suffolk County Mental Health Project cohort of consecutive first admissions with psychosis recruited from September 1989 to December 1995 and subsequently followed for 20 years, focusing on people with schizophrenia (n=146) and bipolar disorder (n=87). The time course of weight gain was examined using a 2 (group) × 5 (time) mixed-model repeated measures ANOVA, and body mass index (BMI) scores at the first (6 months) and second (2 years) assessments were compared to examine whether early overweight predicted later obesity. Results There was a statistically significant effect of time, F(1,210)=68.06, p<.001, and diagnosis on BMI, F(1,210)= 29.18, p<.001, but not the interaction of time × diagnosis, F(1,210)=0.88, p=.48. Most participants had normal BMIs at the first two assessments. Early overweight was a predictor of eventual obesity for both groups. At the 20 year follow-ups, approximately 50% of the bipolar and 62% of the schizophrenia sample were obese, with greater prevalence of obesity in schizophrenia at each assessment (all p<.02), except for years 4 (p=.12) and 20 (p=.27). Conclusions Nearly two thirds of the participants with schizophrenia and over half with bipolar disorder were obese 20 years after first hospitalization for psychosis, considerably higher than the rate for adults in New York State (27%). Early intervention may be required to prevent long-term consequences of obesity-related morbidity and mortality.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Twenty‐year progression of body mass index in a county‐wide cohort of people with schizophrenia and bipolar disorder identified at their first episode of psychosis

et al. 2017

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“…These patients have a doubled risk of dying from CVD, especially at an earlier age . Traditionally, the focus has been on schizophrenia, but CVD is of equal concern for patients with bipolar disorder or MDD . For example, MDD raises CVD risk 2.4 times (41% of MDD patients are at increased risk) , also prospectively .…”

Section: Introductionmentioning

confidence: 99%

Effects of oxidative stress on fatty acid‐ and one‐carbon‐metabolism in psychiatric and cardiovascular disease comorbidity

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Mocking

Lok

et al. 2014

Acta Psychiatr Scand

109

129

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ObjectiveCardiovascular disease (CVD) is the leading cause of death in severe psychiatric disorders (depression, schizophrenia). Here, we provide evidence of how the effects of oxidative stress on fatty acid (FA) and one-carbon (1-C) cycle metabolism, which may initially represent adaptive responses, might underlie comorbidity between CVD and psychiatric disorders.MethodWe conducted a literature search and integrated data in a narrative review.ResultsOxidative stress, mainly generated in mitochondria, is implicated in both psychiatric and cardiovascular pathophysiology. Oxidative stress affects the intrinsically linked FA and 1-C cycle metabolism: FAs decrease in chain length and unsaturation (particularly omega-3 polyunsaturated FAs), and lipid peroxidation products increase; the 1-C cycle shifts from the methylation to transsulfuration pathway (lower folate and higher homocysteine and antioxidant glutathione). Interestingly, corresponding alterations were reported in psychiatric disorders and CVD. Potential mechanisms through which FA and 1-C cycle metabolism may be involved in brain (neurocognition, mood regulation) and cardiovascular system functioning (inflammation, thrombosis) include membrane peroxidizability and fluidity, eicosanoid synthesis, neuroprotection and epigenetics.ConclusionWhile oxidative-stress-induced alterations in FA and 1-C metabolism may initially enhance oxidative stress resistance, persisting chronically, they may cause damage possibly underlying (co-occurrence of) psychiatric disorders and CVD. This might have implications for research into diagnosis and (preventive) treatment of (CVD in) psychiatric patients.

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“…The current supplement of Acta Psychiatrica Scandinavica collates the outcomes of a 1‐day standalone symposium (both supplement and symposium were sponsored by Bristol‐Myers Squibb, including editorial support) on 3 November, 2011, in London, England, discussing how to set up a bipolar clinic within existing National Health Service (NHS) services in the UK. This supplement includes four papers – two clinical overview articles and two discussion articles – outlining and discussing the nature of bipolar disorder, disease progression and associated comorbidities, as well as potential routes to recovery through psychotherapeutic interventions delivered in bipolar clinics.…”

mentioning

confidence: 99%

“…However, the risk of developing chronicity through recurring episodes with incomplete remission is high. Young and Grunze discuss studies showing that patients with bipolar disorder are at a high risk of developing medical comorbidities, such as metabolic syndrome, diabetes and cardiovascular disease , partly as a consequence of standard pharmacotherapy . Regular physical health monitoring is required for the prevention and management of comorbid conditions .…”

mentioning

confidence: 99%

Not always on the level: service provision for bipolar disorders

Young

2013

Acta Psychiatr Scand

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Physical health of patients with bipolar disorder

Cited by 16 publications

References 9 publications

Twenty‐year progression of body mass index in a county‐wide cohort of people with schizophrenia and bipolar disorder identified at their first episode of psychosis

Twenty‐year progression of body mass index in a county‐wide cohort of people with schizophrenia and bipolar disorder identified at their first episode of psychosis

Effects of oxidative stress on fatty acid‐ and one‐carbon‐metabolism in psychiatric and cardiovascular disease comorbidity

Not always on the level: service provision for bipolar disorders

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