Clinical phenotype and genetic risk factors for bipolar disorder with binge eating: an update. (2nd September 2019)

• Record Type: Journal Article
• Authors: Cuellar-Barboza, Alfredo B.; Winham, Stacey J.; Biernacka, Joanna M.; Frye, Mark A.; McElroy, Susan L.
• Is Part Of: Expert review of neurotherapeutics. Volume 19:Number 9(2019)
• Page Start: 867
• Page End: 879
• Publication Date: 2019-09-02
• Subjects: Bipolar -- binge eating -- genetics -- GWAS -- eating disorders; Neuropharmacology -- Periodicals; 615.7805
• DOI: 10.1080/14737175.2019.1638764
• Languages: English
• ISSNs: 1473-7175

Abstract

ABSTRACT: Introduction : Clinical and genetic study of psychiatric conditions has underscored the co-occurrence of complex phenotypes and the need to refine them. Bipolar Disorder (BD) and Binge Eating (BE) behavior are common psychiatric conditions that have high heritability and high co-occurrence, such that at least one quarter of BD patients have BE (BD + BE). Genetic studies of BD alone and of BE alone suggest complex polygenic risk models, with many genetic risk loci yet to be identified. Areas covered : We review studies of the epidemiology of BD+BE, its clinical features (cognitive traits, psychiatric comorbidity, and role of obesity), genomic studies (of BD, eating disorders (ED) defined by BE, and BD + BE), and therapeutic implications of BD + BE. Expert opinion : Subphenotyping of complex psychiatric disorders reduces heterogeneity and increases statistical power and effect size; thus, it enhances our capacity to find missing genetic (and other) risk factors. BD + BE has a severe clinical picture and genetic studies suggests a distinct genetic architecture. Differential therapeutic interventions may be needed for patients with BD + BE compared with BD patients without BE. Recognizing the BD + BE subphenotype is an example of moving towards more precise clinical and genetic entities.