title: Illness burden and medical comorbidity in the Systematic Treatment Enhancement Program for Bipolar Disorder.
abstract: OBJECTIVE
  Coexisting chronic medical conditions are common in bipolar disorder. Here, we report the prevalence and correlates of medical comorbidity in patients enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). We were particularly interested in associations between variables reflecting illness chronicity and burden with comorbid medical conditions.
  
  
  METHODS
  We used intake data from the open-label component of the STEP-BD. History of medical comorbidity was obtained from the affective disorders evaluation, and its presence was the outcome of interest. The sample size in analyses varied from 3399 to 3534. We used multiple Poisson regression to obtain prevalence ratios.
  
  
  RESULTS
  The prevalence of any medical comorbidity in the sample was 58.8%. In addition to demographic variable, several clinical characteristics were associated with the frequency of medical comorbidity. Having more than 10 previous mood episodes, childhood onset, smoking, lifetime comorbidity with anxiety, and substance use disorders were independently associated with having a medical comorbidity in the final multivariate model.
  
  
  CONCLUSIONS
  The results presented here reveal strong associations between variables related to illness chronicity and medical burden in bipolar disorder. This lends further support to recent multidimensional models incorporating medical morbidity as a core feature of bipolar disorder.
authors.affiliation: National Institute for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
authors.forename: P V
authors.initials: PV
authors.lastname: Magalhães
authors.forename: F
authors.initials: F
authors.lastname: Kapczinski
authors.forename: A A
authors.initials: AA
authors.lastname: Nierenberg
authors.forename: T
authors.initials: T
authors.lastname: Deckersbach
authors.forename: D
authors.initials: D
authors.lastname: Weisinger
authors.forename: S
authors.initials: S
authors.lastname: Dodd
authors.forename: M
authors.initials: M
authors.lastname: Berk
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D009422:Nervous System Diseases / Q000453:epidemiology*; D015995:Prevalence; D013959:Thyroid Diseases / Q000453:epidemiology*