title: Co-morbidity in Bipolar Disorder: A Retrospective Study.
abstract: BACKGROUND
  Bipolar disorder is a relatively common, long-term, and disabling psychiatric illness that is associated with high levels of functional impairment, morbidity, mortality, and an increased risk of suicide. Psychiatric co-morbidity in bipolar disorder ranges from 57.3% to 74.3%, whereas medical co-morbidity varies from 2.7-70%. Indian scenario in this aspect is not clear.
  
  
  METHODS
  The objective was to ascertain the prevalence of physical and psychiatric co-morbidities in patients attending a tertiary care center over a period of 1 year and its relationship with socio-demographic and clinical variables. One hundred and twenty-five case record files were included in the review. OPCRIT software was used for re-establishing the diagnosis of bipolar disorder, which yielded 120 cases. A semi-structured pro-forma, specifically designed for the study, was used to collect the socio-demographic and clinical details.
  
  
  RESULTS
  Co-morbid psychiatric disorders were found in 52 (43.3%) of the sample, whereas co-morbid physical illness was present in 77 (64.2%) patients. The most common psychiatric disorder associated was substance use disorder (27.5%), whereas co-morbid cardiovascular disorder was the most frequent physical diagnosis in the sample (20%).
  
  
  CONCLUSIONS
  The prevalence of co-morbid psychiatric disorders in bipolar patients was lower than that reported in western literature. It could be related to retrospective nature of study or reflect true lower prevalence rates. Also, certain disorders such as eating disorders were absent in our sample, and migraine diagnosis was very infrequent.
authors.affiliation: Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Ravindra Neelakanthappa
authors.initials: RN
authors.lastname: Munoli
authors.affiliation: Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Samir Kumar
authors.initials: SK
authors.lastname: Praharaj
authors.affiliation: Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Podila Satya Venkata Narasimha
authors.initials: PS
authors.lastname: Sharma
keywords: Bipolar disorder; co-morbidity; mood disorder