title: Clinical phenotype of bipolar disorder with comorbid binge eating disorder.
abstract: BACKGROUND
  To explore the relationship between binge eating disorder (BED) and obesity in patients with bipolar disorder (BP).
  
  
  METHODS
  717 patients participating in the Mayo Clinic Bipolar Biobank completed structured diagnostic interviews and questionnaires for demographic and illness-related variables. They also had weight and height measured to determine body mass index (BMI). The effects of BED and obesity (BMI≥30 kg/m(2)), as well as their interaction, were assessed on one measure of general medical burden and six proxies of psychiatric illness burden.
  
  
  RESULTS
  9.5% of patients received a clinical diagnosis of BED and 42.8% were obese. BED was associated with a significantly elevated BMI. Both BED and obesity were associated with greater psychiatric and general illness burden, but illness burden profiles differed. After controlling for obesity, BED was associated with suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. After controlling for BED status, obesity was associated with greater general medical comorbidity, but lower substance abuse comorbidity. There were no significant interaction effects between obesity and BED, or BMI and BED, on any illness burden outcome.
  
  
  CONCLUSIONS
  There may have been insufficient power to detect interactions between BED and obesity.
  
  
  CONCLUSIONS
  Among patients with BP, BED and obesity are highly prevalent and correlated, but associated with different profiles of enhanced illness burden. As the association of BED with greater psychiatric illness burden remained significant even after accounting for the effect of obesity, BP with BED may represent a clinically important sub-phenotype.
authors.affiliation: Lindner Center of HOPE, 4075 Old Western Road, Mason, OH 45040, USA. susan.mcelroy@lindnercenter.org
authors.forename: Susan L
authors.initials: SL
authors.lastname: McElroy
authors.forename: Scott
authors.initials: S
authors.lastname: Crow
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Biernacka
authors.forename: Stacey
authors.initials: S
authors.lastname: Winham
authors.forename: Jennifer
authors.initials: J
authors.lastname: Geske
authors.forename: Alfredo B
authors.initials: AB
authors.lastname: Cuellar Barboza
authors.forename: Miguel L
authors.initials: ML
authors.lastname: Prieto
authors.forename: Mohit
authors.initials: M
authors.lastname: Chauhan
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Seymour
authors.forename: Nicole
authors.initials: N
authors.lastname: Mori
authors.forename: Mark A
authors.initials: MA
authors.lastname: Frye
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000175:diagnosis* / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology; D015992:Body Mass Index; D001835:Body Weight; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D010641:Phenotype; D015995:Prevalence; D013405:Suicide
keywords: Binge eating disorder; Bipolar disorder; Obesity