title: Can body mass index help predict outcome in patients with bipolar disorder?
abstract: OBJECTIVE
  Several studies have reported higher prevalence of obesity in patients suffering from bipolar disorder (BD). To study the relation of elevated body mass index (BMI) in patients with BD more closely, we investigated differences in sociodemographic, clinical, and medical characteristics with respect to BMI, with the hypothesis that BMI is related to prognosis and outcome.
  
  
  METHODS
  We measured the BMI of 276 subjects of a tertiary care sample from the Maritime Bipolar Registry. Subjects were 16 to 83 years old, with psychiatric diagnoses of bipolar I disorder (n = 186), bipolar II disorder (n = 85), and BD not otherwise specified (n = 5). The registry included basic demographic data and details of the clinical presentation. We first examined the variables showing a significant association with BMI; subsequently, we modeled the relationship between BMI and psychiatric outcome using structural equation analysis.
  
  
  RESULTS
  The prevalence of obesity in our sample was 39.1%. We found higher BMI in subjects with a chronic course (p < 0.001) and longer duration of illness (p = 0.02), lower scores on the Global Assessment of Functioning Scale (p = 0.02), and on disability (p = 0.002). Overweight patients had more frequent comorbid subthreshold social (p = 0.02) and generalized anxiety disorders (p = 0.05), diabetes mellitus type II (p < 0.001), and hypertension (p = 0.001). Subjects who achieved complete remission of symptoms on lithium showed significantly lower BMI (p = 0.01).
  
  
  CONCLUSIONS
  Our findings suggest that BMI is associated with the prognosis and outcome of BD. Whether this association is causal remains to be determined.
authors.affiliation: Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia B3H 2E2, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Calkin
authors.forename: Caroline
authors.initials: C
authors.lastname: van de Velde
authors.forename: Martina
authors.initials: M
authors.lastname: Růzicková
authors.forename: Claire
authors.initials: C
authors.lastname: Slaney
authors.forename: Julie
authors.initials: J
authors.lastname: Garnham
authors.forename: Tomas
authors.initials: T
authors.lastname: Hajek
authors.forename: Claire
authors.initials: C
authors.lastname: O'Donovan
authors.forename: Martin
authors.initials: M
authors.lastname: Alda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis*; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D015233:Models, Statistical; D009765:Obesity / Q000150:complications; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D013223:Statistics as Topic; D055815:Young Adult
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