title: Relationship of general medical burden, duration of illness and age in patients with bipolar I disorder.
abstract: OBJECTIVE
  This study was aimed at evaluating general medical burden in a group of 111 patients with bipolar I disorder.
  
  
  METHODS
  Data were drawn from participants entering the Bipolar Disorder Center for Pennsylvanians (BDCP) protocol. General medical burden was assessed by completing the Cumulative Illness Rating Score (CIRS) from chart review.
  
  
  RESULTS
  The mean age of the sample was 42.1 (11.5), mean CIRS total score was 4.7 (2.9), and mean number of categories endorsed was 3.4 (1.7). Medical burden showed a positive relationship with increasing age and with duration of illness. CIRS scores and number of organ/system categories endorsed were significantly higher in patients with more than 21 years of illness than in patients with 0-9 years of illness (p<.0001) or with 10-20 years of illness (p<.0001). Medical burden was related to duration of illness even after controlling for age. The most frequently endorsed illness categories were cardiovascular disease, (with hypertension and hyperlipidemia being the most frequent conditions) and endocrine/metabolic (with obesity, thyroid dysfunction, and type 2 diabetes being the most common conditions).
  
  
  CONCLUSIONS
  Patients with bipolar disorder carry a substantial burden of general medical conditions, related to age and duration of illness. These results suggest that the development and testing of specific interventions that target medical risk factors and medical burden in patients with bipolar disorder are urgently needed, especially early in the course of the illness, when patients appear to accumulate medical comorbidity at a rapid rate.
authors: Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213, USA. sorecai@upmc.edu
authors: Isabella
authors: I
authors: Soreca
authors: Andrea
authors: A
authors: Fagiolini
authors: Ellen
authors: E
authors: Frank
authors: Patricia R
authors: PR
authors: Houck
authors: Wesley K
authors: WK
authors: Thompson
authors: David J
authors: DJ
authors: Kupfer
mesh_terms: D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D012307:Risk Factors