General medical conditions are associated with delay to treatment in patients with bipolar disorder.
BACKGROUND
Bipolar disorder (BPD) is associated with worse physical health. Indeed patients with BPD more frequently suffer from medical conditions such as cardiovascular illness, hypertension, diabetes, hypothyroidism, respiratory disease, liver disease, peptic ulcer, and arthritis. Since some clinical characteristics have been associated with worse course and outcome of BPD, it is possible that they might also bring to an increased medical burden in patients with BPD. The aim of the present report is to assess the prevalence of medical conditions in patients with BPD, and to determine the clinical variables associated with the presence of a medical condition.


METHODS
Charts of patients with BPD I and II were reviewed: socio-demographic and clinical information were collected. Medical conditions were classified by the ICD-10 and grouped according to the Cumulative Illness Rating Scales in: cardiac, vascular, hematopoietic, respiratory, ear/nose/throat, upper and lower gastrointestinal, hepatic, renal, genitourinary, musculoskeletal, neurologic, endocrine/metabolic. The associations between the presence of medical conditions and demographic/clinical variables of BPD were then analyzed.


RESULTS
Charts of 309 patients were included in the study. 170 (55%) patients had at least one medical condition. The most common were endocrine/metabolic disease (23%), and vascular disease (21%). Having a medical condition was associated with longer duration of untreated illness and female gender.


CONCLUSIONS
Patients with BPD have high rates of medical conditions, especially hypertension and metabolic disorders. A longer duration of untreated illness is associated with having a medical condition, probably due to the long-lasting adoption on unhealthy lifestyles not counterbalanced by treatment and psychoeducation.
Mood and Anxiety Disorders Unit, Department of Neuroscience, University of Turin, Turin, Italy.
Giuseppe
G
Maina
Elisa
E
Bechon
Sylvia
S
Rigardetto
Virginio
V
Salvi
D000328:Adult; D017668:Age of Onset; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D002318:Cardiovascular Diseases / Q000453:epidemiology; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D004066:Digestive System Diseases / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*
Bipolar disorder; cardiovascular disease; duration of untreated illness; general medical conditions