Significantly Higher Prevalence Rate of Asthma and Bipolar Disorder Co-Morbidity

Abstract

Asthma and bipolar disorder (BD) are 2 distinct diseases that share similar pathophysiology. This study aimed to determine their relationship thorough a meta-analysis of articles on their comorbidity rate.The aim of the study is to examine the overall prevalence rate of BD in asthmatic patients and of asthma in BD patients compared to healthy controls.Electronic research of PubMed and ClinicalTrials.gov was performed.Articles discussing the prevalence rate of BD in patients with/without asthma and the prevalence rate of asthma in those with/without BD, as well as clinical trials in humans and case-controlled trials or cohort studies, were all included. Case reports or series and nonclinical trials were excluded.Through a random-effects model, a meta-analysis of the results of 4 studies comparing the prevalence rate of BD in patients with/without asthma, and in 6 studies comparing the prevalence rate of asthma in subjects with/without BD were performed.There were significantly higher prevalence rates of BD in asthmatic patients than in healthy controls (P < .001) and of asthma in BD patients than in healthy controls (P < .001). Only the patient's mean age significantly modulated the odds ratio of the prevalence rate of asthma in BD patients (slope = 0.015, P < .001).Only 10 studies were included and most were cross-sectional studies. The possible confounding effect of medication on BD or asthma onset was not investigated. Any possible etiology of the comorbidity was also not determined.This meta-analysis highlights the importance of the significantly high comorbid rate of BD and asthma, and the positive association with age. Special attention must be given to the comorbidity of asthma and BD, especially in older patients.

Systematic assessment of environmental risk factors for bipolar disorder: an umbrella review of systematic reviews and meta‐analyses

“…One study of the 65 articles selected for full‐text review was excluded because a more recent publication had re‐analysed the data . Seven of the 16 eligible articles had a quantitative synthesis providing a summary estimate of the association of the risk factor and BD . Individual study data were available for six publications .…”

“…Meta‐analyses provided evidence for seven environmental factors, and included 54 studies in total (median=8; interquartile range [IQR]=5−10). Three of the factors were medical comorbidities (asthma, irritable bowel syndrome [IBS] and obesity), and one was seropositivity for a typical perinatal pathogen ( T. gondii ). The remaining three were childhood adversity, head injury, and exposure to obstetric complications .…”

“…Six (85.7%) of seven meta‐analyses reported effects that were significant at a nominal P value of .05. Four (57.1%) were significant at P values <.001 under random effects modelling (Table ): asthma, childhood adversity, IBS, and obesity . The 95% prediction interval rule under random‐effects modelling did not include the null value only in the meta‐analysis of IBS .…”

“…The 95% prediction interval rule under random‐effects modelling did not include the null value only in the meta‐analysis of IBS . The meta‐analysis that investigated the prevalence of BD in individuals with asthma did not provide information with which to calculate prediction intervals.…”

“…The meta‐analyses that investigated childhood adversity, exposure to obstetric complications or T. gondii infection included only case−control studies. The meta‐analyses that investigated asthma and head injury included cross‐sectional and case−control studies. Only the meta‐analysis that investigated IBS as a risk factor for BD included only retrospective cohort studies …”