Medical comorbidity in women and men with bipolar disorders: a population-based controlled study.
OBJECTIVE
Rarely has validated information on chronic medical comorbidity been presented for persons with bipolar disorder. To deliver appropriate health services, it is important to understand the prevalence of chronic medical conditions in this population. This study examines chronic medical comorbidity using validated methodology in persons with bipolar disorder.


METHODS
This is a retrospective study of a 100% sample of administrative claims (1996-2001) from Wellmark Blue Cross Blue Shield. Three thousand five hundred fifty-seven subjects had bipolar I disorder and did not have claims for schizophrenia or schizoaffective disorder. Controls had no documented claims for psychiatric conditions. Using validated methodology, inpatient and outpatient claims were used to determine prevalence of 44 chronic medical conditions. Odds ratios (ORs) were adjusted for age, gender, residence, and nonmental healthcare utilization.


RESULTS
Persons with bipolar disorder were young (mean age, 38.8 years) and significantly more likely to have medical comorbidity, including three or more chronic conditions (41% versus 12%, p < .001) compared with controls. Elevated ORs were found for conditions spanning all organ systems. Hyperlipidemia, lymphoma, and metastatic cancer were the only conditions less likely to occur in persons with bipolar disorder.


CONCLUSIONS
Bipolar disorders are associated with substantial chronic medical burden. Familiarity with conditions affecting this population may assist in programs aimed at providing medical care for the chronically mentally ill.
Carney
Caroline P
CP
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46250, USA. ccarneyd@iupui.edu
Jones
Laura E
LE
D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology*; D054598:Blue Cross Blue Shield Insurance Plans / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003953:Diagnosis-Related Groups; D004700:Endocrine System Diseases / Q000453:epidemiology; D005260:Female; D018755:GABA Agonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D007484:Iowa / Q000453:epidemiology; D018020:Lithium Compounds / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012725:Sexual Behavior; D012907:Smoking / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology
D018755:GABA Agonists; D018020:Lithium Compounds