Medical and substance-related comorbidity in bipolar disorder: translational research and treatment opportunities.
It is well established that individuals with bipolar disorder are differentially affected by substance-related as well as medical disorders (ie, cardiometabolic disorders, respiratory disorders, neurological disorders, and infectious diseases). Emerging evidence indicates that some comorbid conditions (eg, diabetes mellitus) in bipolar individuals may be subserved by overlapping neurobiological networks. Disturbances in glucocorticoid/insulin signaling and immunoinflammatory effector systems are points of pathophysiological commonality between bipolar disorder and "stress-sensitive" medical disorders. Subphenotyping bipolar disorder as a function of comorbidity and temporality of onset may provide an opportunity for refining disease pathophysiological models and developing innovative disease-modifying therapies.
McIntyre
Roger S
RS
Department of Psychiatry and Pharmacology, University of Toronto, ON, Canada. roger.mcintyre@uhn.on.ca
Nguyen
Ha T
HT
Soczynska
Joanna K
JK
Lourenco
Maria Teresa C
MT
Woldeyohannes
Hanna O
HO
Konarski
Jakub Z
JZ
D001714:Bipolar Disorder / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D008659:Metabolic Diseases / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology