The relationship of bulimia and anorexia nervosa with bipolar disorder and its temperamental foundations.
BACKGROUND
Earlier studies have suggested a relationship between bipolar disorder (BP) and eating disorders (ED), more specifically, bulimia nervosa (BN) and bipolar II disorder (BP-II). In the present report we extend this relationship to broader definitions of bipolarity.


METHODS
Semi-structured interview of 201 patients with DSM-IV criteria for major affective disorders combined with Akiskal and Mallya criteria for Affective temperaments. To diagnose lifetime comorbid eating disorders DSM-IV criteria for eating disorders (Bulimia Nervosa, BN, Anorexia, AN) were used.


RESULTS
33 patients had an eating disorder. When compared to patients without ED the patients with ED had a higher prevalence of bipolar disorders. Using strict DSM-IV criteria, this association was only significant for BN (OR) 4.5 (95% CI 1.1-17.6). When using a broader index of bipolarity including patients having affective temperaments, a significant relation was found for BN (OR) 9.1 (95% CI 1.1-73.6), and for patients with a lifetime history of both BN and AN (OR) 8.6 (95% CI 1.1-70.2).We also found patients with ED to have a significantly higher prevalence of affective temperaments, an earlier onset of major affective disorder and to have more depressive episodes.


CONCLUSIONS
Non-blind evaluation of diagnosis for mood, eating disorders and affective temperaments.


CONCLUSIONS
In line with previous reports we describe an association between bulimia nervosa and bipolar disorder. Furthermore we report a relationship between lifetime bulimia and anorexia and cyclothymic and related affective temperaments.
Lunde
Anna V
AV
Department of Clinical Psychiatry Risskov, Aarhus University Hospital, Denmark; International Mood Center, University of California, La Jolla, CA, USA.
Fasmer
Ole B
OB
Akiskal
Kareen K
KK
Akiskal
Hagop S
HS
Oedegaard
Ketil J
KJ
D000328:Adult; D000856:Anorexia Nervosa / Q000453:epidemiology / Q000523:psychology*; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology*; D052018:Bulimia Nervosa / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D013694:Temperament