title: General medical burden in bipolar disorder: findings from the LiTMUS comparative effectiveness trial.
abstract: OBJECTIVE
  This study examined general medical illnesses and their association with clinical features of bipolar disorder.
  
  
  METHODS
  Data were cross-sectional and derived from the Lithium Treatment - Moderate Dose Use Study (LiTMUS), which randomized symptomatic adults (n = 264 with available medical comorbidity scores) with bipolar disorder to moderate doses of lithium plus optimized treatment (OPT) or to OPT alone. Clinically significant high and low medical comorbidity burden were defined as a Cumulative Illness Rating Scale (CIRS) score ≥4 and <4 respectively.
  
  
  RESULTS
  The baseline prevalence of significant medical comorbidity was 53% (n = 139). Patients with high medical burden were more likely to present in a major depressive episode (P = .04), meet criteria for obsessive-compulsive disorder (P = .02), and experience a greater number of lifetime mood episodes (P = 0.02). They were also more likely to be prescribed a greater number of psychotropic medications (P = .002). Sixty-nine per cent of the sample was overweight or obese as defined by body mass index (BMI), with African Americans representing the racial group with the highest proportion of stage II obesity (BMI ≥35; 31%, n = 14).
  
  
  CONCLUSIONS
  The burden of comorbid medical illnesses was high in this generalizable sample of treatment-seeking patients and appears associated with worsened course of illness and psychotropic medication patterns.
authors: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors: D E
authors: DE
authors: Kemp
authors: L G
authors: LG
authors: Sylvia
authors: J R
authors: JR
authors: Calabrese
authors: A A
authors: AA
authors: Nierenberg
authors: M E
authors: ME
authors: Thase
authors: N A
authors: NA
authors: Reilly-Harrington
authors: M J
authors: MJ
authors: Ostacher
authors: A C
authors: AC
authors: Leon
authors: T A
authors: TA
authors: Ketter
authors: E S
authors: ES
authors: Friedman
authors: C L
authors: CL
authors: Bowden
authors: D J
authors: DJ
authors: Rabideau
authors: M
authors: M
authors: Pencina
authors: D V
authors: DV
authors: Iosifescu
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D001249:Asthma / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology*; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology* / Q000208:ethnology; D011619:Psychotropic Drugs / Q000627:therapeutic use; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: bipolar disorder; effectiveness; lithium; medical comorbidity; obesity