Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 280, Issue -, Pages 409-431Publisher
ELSEVIER
DOI: 10.1016/j.jad.2020.11.015
Keywords
Bipolar disorder; Anorexia nervosa; Bulimia nervosa; Binge eating disorder; Prevalence; Comorbidity; Review; Meta-analysis, Psychiatry, Mental health; Neuroscience
Categories
Funding
- Health Education England (HEE) [ICA-CL-2017-03-001]
- National Institute for Health Research (NIHR) [ICA-CL-2017-03-001]
- NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
- Medical Research Council
- Guys and St Thomas Charity (GSTT)
- COMPASS Pathways Limited
- Brain and Behavior Research Foundation
- Physician's Services Incorporated Foundation
- Stanley Medical Research Institute
- University of Toronto
- NHMRC Senior Principal Research Fellowship [1156072]
- AB-Biotics
- Abbott
- Allergan
- Angelini
- AstraZeneca
- Bristol-Myers Squibb
- Dainippon Sumitomo Pharma
- Farmindustria
- Ferrer
- Forest Research Institute
- Galenica
- Gedeon Richter
- Glaxo-Smith-Kline
- Janssen
- Lundbeck
- Otsuka
- Pfizer
- Roche
- Sage
- Sanofi-Aventis
- Servier
- Shire
- Sunovion
- Takeda
- Brain and Behaviour Foundation
- Generalitat de Catalunya (PERIS)
- Spanish Ministry of Science, Innovation and Universities (CIBERSAM)
- EU Horizon 2020
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Research indicates that the comorbidity rates of bipolar disorder (BD) and eating disorders (ED) vary across different diagnostic groups, rather than being determined by the direction between BD and ED. Future studies should focus on the risk, timeline, clinical impact, and management of comorbid BD and ED across different age groups.
Background: There are scarce and discrepant data about the prevalence and correlates of co-occurring eating disorders (EDs) among people with a primary diagnosis of bipolar disorder (BD), and vice-versa, compelling a systematic review and meta-analysis on the matter. Methods: MEDLINE/PsycINFO databases were systematically searched for original studies documenting BD reversible arrow ED comorbidity across the lifespan, from inception up until April 20th, 2020. Random-effects meta-analysis and meta-regression analyses were conducted, accounting for multiple moderators. Results: Thirty-six studies involved 15,084 primary BD patients. Eleven studies encompassed 15,146 people with primary EDs. Binge eating disorder (BED) occurred in 12.5% (95%C.I.=9.4-16.6%, I-2=93.48%) of BDs, while 9.1% (95%C.I.=3.3-22.6%) of BEDs endorsed BD. Bulimia Nervosa (BN) occurred in 7.4% (95%C.I.=6-10%) of people with BD, whereas 6.7% (95%C.I.=12-29.2%) of subjects with BN had a diagnosis of BD. Anorexia Nervosa (AN) occurred in 3.8% (95%C.I.=2-6%) of people with BDs; 2% (95%C.I.=1-2%) of BD patients had a diagnosis of AN. Overall, BD patients with EDs had higher odds of being female vs. non-ED controls. Several moderators yielded statistically significant differences both within- and between different types of BDs and EDs. Limitations: Scant longitudinal studies, especially across different EDs and pediatric samples. High heterogeneity despite subgroup comparisons. Limited discrimination of the quality of the evidence. Conclusions: The rates of BD reversible arrow ED comorbidity vary across different diagnostic groups, more than they do according to the direction of BD reversible arrow ED. Further primary studies should focus on the risks, chronology, clinical impact, and management of the onset of intertwined BD reversible arrow ED across different ages, promoting a continuum approach.
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