Bipolar disorders and Wilson's disease.
BACKGROUND
The aim of this study was to determine the risk for Bipolar Disorder (BD) in Wilson's disease (WD) and to measure the impaired Quality of Life (QL) in BD with WD using standardized psychiatric diagnostic tools and a case control design.


METHODS
This was a case control study. The cases were 23 consecutive patients with WD treated at the University Hospital in Cagliari, Italy, and the controls were 92 sex- and age-matched subjects with no diagnosis of WD who were randomly selected from a database used previously for an epidemiological study. Psychiatric diagnoses according to DSM-IV criteria were determined by physicians using structured interview tools (ANTAS-SCID). QL was measured by means of SF-12.


RESULTS
Compared to controls, WD patients had lower scores on the SF-12 and higher lifetime prevalence of DSM-IV major depressive disorders (OR = 5.7, 95% CI 2.4-17.3) and bipolar disorders (OR = 12.9, 95% CI 3.6-46.3). BD was associated with lower SF-12 in WD patients.


CONCLUSIONS
This study was the first to show an association between BD and WD using standardized diagnostic tools and a case control design. Reports in the literature about increased schizophrenia-like psychosis in WD and a lack of association with bipolar disorders may thus have been based on a more inclusive diagnosis of schizophrenia in the past. Our findings may explain the frequent reports of loss of emotional control, hyperactivity, loss of sexual inhibition, and irritability in WD patients. This study was limited by a small sample size.
University of Cagliari, Italy, Cagliari, Italy. mgcarta@tiscali.it
Mauro Giovanni
MG
Carta
Orazio
O
Sorbello
Maria Francesca
MF
Moro
Krishna M
KM
Bhat
Enrico
E
Demelia
Alessandra
A
Serra
Gioia
G
Mura
Federica
F
Sancassiani
Mario
M
Piga
Luigi
L
Demelia
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006527:Hepatolenticular Degeneration / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012306:Risk