Medical comorbidity in bipolar disorder: reprioritizing unmet needs

Abstract

Somatic health issues in individuals with bipolar disorder are ubiquitous, under-recognized and suboptimally treated. Facile screening for risk factors and laboratory abnormalities along with behavioral modification for reducing medical comorbidity are warranted.

Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

“…31,32 In addition to general medical conditions such as cardiovascular, endocrine, and metabolic diseases, 8,33 patients with BD usually have a wide range of modifiable cardiovascular risk factors such as obesity, smoking, physical inactivity, and poor eating habits. 17 As expected and in line with recent studies from other countries, patients with BD had higher prevalence of the selected cardiovascular risk factors when compared with data regarding the Brazilian population, in which recent studies have shown rates of 5-10% for diabetes and around 30% for hypertension and high cholesterol.…”

“…1 Patients with BD are subject to premature death from all causes when compared to the general population 2 and usually have several comorbid general medical conditions associated with worse outcomes and higher burden of disease. [3][4][5] Increased rates of obesity, 6,7 diabetes, 8 hypertension, 9 dyslipidemia, 10 and metabolic syndrome [11][12][13] have been reported in recent clinical and epidemiological studies. 14,15 In addition to being exposed to the weight gain effects of the pharmacological treatment, BD patients are more likely to have sedentary lifestyles and poor dietary habits, 16 which are well-established cardiovascular risk factors.…”

Diabetes in first manic episode

“…Gukokortikoid/insülin sinyal mekanizmaları ve immünoinflamatu-ar efektör İUB ile stres duyarlı genel tıbbi durumlar arasındaki patofizyolojiye işaret eden kesişim noktalarıdır (16). İUB'de değişen beyin enerji metabolizması ve beyin glukoz metabolizmasındaki değişiklikler her iki hastalığın patofizyolojisinde önemli olabilir (17,18).…”

Consenso Español de Salud Física del Paciente con Trastorno Bipolar

“…Aunque está poco estudiado, los datos disponibles sugieren que diversas enfermedades médicas (cardiovasculares, metabólicas, infecciosas, neurológicas y respiratorias) presentan una prevalencia más elevada en estos pacientes 8,9 . Las razones que contribuyen a esta mayor prevalencia son variadas.…”

“…Sin embargo, hay una tendencia a infradiagnosticar e infratratar las enfermedades médicas entre los pacientes psiquiátricos en general y entre los pacientes bipolares en particular 9,[13][14][15] . De esta situación se deriva la consecuencia de sensibilizar a todos los profesionales de la salud sobre la necesidad de prevenir y tratar adecuadamente las enfermedades físicas en estos pacientes 16 .…”