General medical burden in bipolar disorder: findings from the LiTMUS comparative effectiveness trial. (7th March 2013)

• Record Type: Journal Article
• Authors: Kemp, D. E.; Sylvia, L. G.; Calabrese, J. R.; Nierenberg, A. A.; Thase, M. E.; Reilly‐Harrington, N. A.; Ostacher, M. J.; Leon, A. C.; Ketter, T. A.; Friedman, E. S.; Bowden, C. L.; Rabideau, D. J.; Pencina, M.; Iosifescu, D. V.
• Is Part Of: Acta psychiatrica Scandinavica. Volume 129:Number 1(2014:Jan.)
• Page Start: 24
• Page End: 34
• Publication Date: 2013-03-07
• Subjects: Psychiatry -- Periodicals; 616.89
• DOI: 10.1111/acps.12101
• Languages: English
• ISSNs: 0001-690X

Abstract

<abstract abstract-type="main" xml:lang="en" id="acps12101-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acps12101-sec-0001" sec-type="section"> <title>Objective</title> <p>This study examined general medical illnesses and their association with clinical features of bipolar disorder.</p> </sec> <sec id="acps12101-sec-0002" sec-type="section"> <title>Method</title> <p>Data were cross‐sectional and derived from the Lithium Treatment – Moderate Dose Use Study (LiTMUS), which randomized symptomatic adults (<italic>n</italic> = 264 with available medical comorbidity scores) with bipolar disorder to moderate doses of lithium plus optimized treatment (OPT) or to OPT alone. Clinically significant high and low medical comorbidity burden were defined as a Cumulative Illness Rating Scale (CIRS) score ≥4 and <4 respectively.</p> </sec> <sec id="acps12101-sec-0003" sec-type="section"> <title>Results</title> <p>The baseline prevalence of significant medical comorbidity was 53% (<italic>n</italic> = 139). Patients with high medical burden were more likely to present in a major depressive episode (<italic>P</italic> = .04), meet criteria for obsessive–compulsive disorder (<italic>P</italic> = .02), and experience a greater number of lifetime mood episodes (<italic>P</italic> = 0.02). They were also more likely to be prescribed a greater number of psychotropic medications (<italic>P</italic> = .002). Sixty‐nine per cent of the sample was overweight or obese as defined by body mass index (BMI), with African Americans representing the racial group with the highest proportion of stage II obesity (BMI ≥35; 31%, <italic>n</italic> = 14).</p> </sec> <sec id="acps12101-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The burden of comorbid medical illnesses was high in this generalizable sample of treatment‐seeking patients and appears associated with worsened course of illness and psychotropic medication patterns.</p> </sec> </abstract>