Public health significance of bipolar disorder: implications for early intervention and prevention

Conus, Philippe; Macneil, Craig A.; McGorry, Patrick D.

doi:10.1111/bdi.12137

Cited by 75 publications

(54 citation statements)

References 83 publications

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“…Relative to people with normal weight, all‐cause mortality of obese persons is higher . We surmise that the increased prevalence of obesity in individuals with SCZ and BP puts them at greater health and mortality risk than the population at large, consistent with previous observations . The trajectory of weight gain is also important.…”

Section: Discussionsupporting

confidence: 88%

“…37 We surmise that the increased prevalence of obesity in individuals with SCZ and BP puts them at greater health and mortality risk than the population at large, consistent with previous observations. 8,9,11,[19][20][21] The trajectory of weight gain is also important. Obese persons with upward weight gain trajectories, even after controlling for demographic and socioeconomic characteristics, smoking status, limitations in activities of daily living, and a wide range of chronic illnesses, have even higher mortality risk than those with static obesity.…”

Section: Discussionmentioning

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: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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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“…34 The possibility of pluripotential (shared) early stages across different disorders has been proposed based on a degree of overlap in nonspecific early risk syndromes. 7,30,35 However, this proposal is problematic in many ways. It ignores the welldocumented and striking differences in developmental history, early illness trajectories, and family history between prototypical schizophrenia and classical recurrent BD.…”

Section: 26mentioning

confidence: 99%

Toward a Comprehensive Clinical Staging Model for Bipolar Disorder: Integrating the Evidence

Duffy

2014

Can J Psychiatry

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Objectives: To describe key findings relating to the natural history and heterogeneity of bipolar disorder (BD) relevant to the development of a unitary clinical staging model. Currently proposed staging models are briefly discussed, highlighting complementary findings, and a comprehensive staging model of BD is proposed integrating the relevant evidence.Method: A selective review of key published findings addressing the natural history, heterogeneity, and clinical staging models of BD are discussed. Results:The concept of BD has broadened, resulting in an increased spectrum of disorders subsumed under this diagnostic category. Different staging models for BD have been proposed based on the early psychosis literature, studies of patients with established BD, and prospective studies of the offspring of parents with BD. The overarching finding is that there are identifiable sequential clinical phases in the development of BD that differ in important ways between classical episodic and psychotic spectrum subtypes. In addition, in the context of familial risk, early risk syndromes add important predictive value and inform the staging model for BD. Conclusions:A comprehensive clinical staging model of BD can be derived from the available evidence and should consider the natural history of BD and the heterogeneity of subtypes. This model will advance both early intervention efforts and neurobiological research. W W WVers un modèle complet de staification clinique du trouble bipolaire : intégrant l'évidence Objectifs : Décrire les principaux résultats concernant l'histoire naturelle et l'hétérogénéité du trouble bipolaire (TB) qui se rapportent à l'élaboration d'un modèle unitaire de stades cliniques. Les modèles de staification présentement proposés sont brièvement présentés, de même que les résultats complémentaires, et un modèle complet de staification du TB est proposé qui intègre les données probantes pertinentes.Méthode : Est présentée une revue sélective des principaux résultats publiés sur l'histoire naturelle, l'hétérogénéité, et les modèles de staification clinique du TB.Résultats : Le concept du TB s'est élargi, ce qui a donné un spectre accru de troubles classés dans cette catégorie diagnostique. Différents modèles de staification du TB ont été proposés d'après la littérature sur la psychose précoce, les études de patients souffrant d'un TB établi, et les études prospectives des enfants de parents souffrant de TB. Le résultat déterminant est qu'il y a des phases cliniques séquentielles identifiables dans le développement du TB qui diffèrent de manière importante entre les sous-types épisodiques classiques et ceux du spectre psychotique. En outre, dans le contexte du risque familial, les syndromes de risque précoce ajoutent une valeur prédictive importante et éclairent le modèle de stadification du TB.Conclusions : Un modèle complet de stadification clinique du TB peut être déduit des données probantes disponibles et devrait tenir compte de l'histoire naturelle du TB et de l'hétérogénéité des sous-types. Ce ...

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“…Linkage studies have revealed that SCZ and bipolar disorder share a number of overlapping features and genetic risk variants . Bipolar disorder is associated with neurocognitive deficits that persist into euthymia after episode resolution . Several meta‐analyses have revealed impairments in the broad domains of attention, processing speed, verbal memory and executive functions, with relative preservation of verbal abilities and intelligence.…”

Section: Introductionmentioning

confidence: 99%

A promoter polymorphism rs2075824 within IMPA2 gene affecting the transcription activity: possible relationship with schizophrenia

Huang

Dai

et al. 2016

J Cellular Molecular Medi

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Previous studies with biological and genetic evidence indicate that the myo‐inositol monophosphatase 2 (IMPA2) gene may influence schizophrenia. We performed a genetic association study in Han Chinese cohorts. Five single nucleotide polymorphisms within IMPA2 promoter region (rs971363, rs971362, rs2075824, rs111410794 and rs111610121), as well as one (rs45442994, in intron 1) that was positively associated in another study, were selected for genotyping in 1397 patients with schizophrenia and 1285 mentally healthy controls. Genotype and allele frequencies were assessed by gender stratification. Interestingly, rs2075824 showed a strong association with schizophrenia (P = 4.1 × 10−4), and the T allele was more frequent in cases than controls [P = 5.6 × 10−5, OR (95% CI) = 1.26 (1.13–1.41)]. In vitro promoter assay showed that the transcription activity of the T allele promoter was higher than that of the C allele promoter and the T allele of rs2075824 contributed to risk for schizophrenia. By stratifying males and females, we found a gender‐specific association for IMPA2 and schizophrenia: the T allele of rs2075824 was more frequent in male cases compared with male controls [P = 1.4 × 10−4, OR (95% CI) = 1.33 (1.15–1.55)]. Our data suggest that a promoter polymorphism of IMPA2 possibly contributed to risk for schizophrenia by elevating transcription activity in Han Chinese individuals.

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Public health significance of bipolar disorder: implications for early intervention and prevention

Abstract: Considering the major impact of BD on patients and society, there is an urgent need for the development of early intervention strategies aimed at earlier detection and more specific treatment of the early phase of the disorder.

Cited by 75 publications

References 83 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

Toward a Comprehensive Clinical Staging Model for Bipolar Disorder: Integrating the Evidence

A promoter polymorphism rs2075824 within IMPA2 gene affecting the transcription activity: possible relationship with schizophrenia

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