Journal
ACTA PSYCHIATRICA SCANDINAVICA
Volume 125, Issue 4, Pages 303-308Publisher
WILEY
DOI: 10.1111/j.1600-0447.2011.01794.x
Keywords
bipolar disorder; medical burden; staging; age at onset; comorbidity; outcome; treatment; mania; depression; course; diabetes; smoking; cardiovascular
Categories
Funding
- National Institute for Translational Medicine, Brazil
- National Institute of Mental Health
- Astra-Zeneca
- Eli Lilly
- Janssen-Cilag
- Servier
- CNPq
- CAPES
- NARSAD
- Stanley Medical Research Institute
- Stanley Medical Research Foundation
- MBF
- NHMRC
- Beyond Blue
- Geelong Medical Research Foundation
- Bristol Myers Squibb
- Glaxo SmithKline
- Glaxo SmithKline, Organon
- Novartis
- Mayne Pharma
- Pamlab
- Shire
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Objective: Coexisting chronic medical conditions are common in bipolar disorder. Here, we report the prevalence and correlates of medical comorbidity in patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). We were particularly interested in associations between variables reflecting illness chronicity and burden with comorbid medical conditions. Method: We used intake data from the open-label component of the STEP-BD. History of medical comorbidity was obtained from the affective disorders evaluation, and its presence was the outcome of interest. The sample size in analyses varied from 3399 to 3534. We used multiple Poisson regression to obtain prevalence ratios. Results: The prevalence of any medical comorbidity in the sample was 58.8%. In addition to demographic variable, several clinical characteristics were associated with the frequency of medical comorbidity. Having more than 10 previous mood episodes, childhood onset, smoking, lifetime comorbidity with anxiety, and substance use disorders were independently associated with having a medical comorbidity in the final multivariate model. Conclusion: The results presented here reveal strong associations between variables related to illness chronicity and medical burden in bipolar disorder. This lends further support to recent multidimensional models incorporating medical morbidity as a core feature of bipolar disorder.
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