Clinical features of bipolar spectrum with binge eating behaviour

Susan L. McElroy, Scott Crow, Thomas J. Blom, Alfredo B. Cuellar-Barboza, Miguel L. Prieto, Marin D Veldic, Stacey J Winham, William V Bobo, Jennifer Geske, Lisa R. Seymour, Nicole Mori, David J. Bond, Joanna M Biernacka, Mark A Frye

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective To determine whether bipolar spectrum disorder with binge eating behavior (BE) is an important clinical sub-phenotype. Methods Prevalence rates and correlates of different levels of BE were assessed in 1114 bipolar spectrum patients participating in a genetic biobank. BE and eating disorders (EDs) were assessed with the Eating Disorder Diagnostic Scale (EDDS). Psychiatric illness burden was evaluated with measures of suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. Medical illness burden was evaluated with body mass index (BMI) and the Cumulative Index Rating Scale (CIRS). Results Thirty percent of patients had any BE and 27% had BE plus an ED diagnosis. Compared with bipolar spectrum patients without BE, bipolar spectrum patients with BE were younger and more likely to be female; had significantly higher levels of eating psychopathology, suicidality, mood instability, and anxiety disorder comorbidity; had a significantly higher mean BMI and a significantly higher rate of obesity; and had a significantly higher medical illness burden. Bipolar spectrum patients with BE but no ED diagnosis were more similar to bipolar spectrum patients without BE than to those with an ED. Nonetheless, the positive predictive value and specificity of BE predicting an ED was 0.90 and 0.96, respectively. Limitations As only two patients had co-occurring anorexia nervosa, these results may not generalize to bipolar spectrum patients with restricting EDs. Conclusion Bipolar spectrum disorder with broadly-defined BE may not be as clinically relevant a sub-phenotype as bipolar spectrum disorder with an ED but may be an adequate proxy for the latter when phenotyping large samples of individuals.

Original languageEnglish (US)
Pages (from-to)95-98
Number of pages4
JournalJournal of Affective Disorders
Volume201
DOIs
StatePublished - Sep 1 2016

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Bulimia
Feeding Behavior
Cost of Illness
Bipolar Disorder
Comorbidity
Anxiety Disorders
Body Mass Index
Phenotype
Feeding and Eating Disorders
Anorexia Nervosa
Proxy
Psychopathology
Mood Disorders
Mental Disorders
Psychotic Disorders
Substance-Related Disorders
Psychiatry
Obesity
Eating

Keywords

  • Binge eating
  • Bipolar spectrum

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Clinical features of bipolar spectrum with binge eating behaviour. / McElroy, Susan L.; Crow, Scott; Blom, Thomas J.; Cuellar-Barboza, Alfredo B.; Prieto, Miguel L.; Veldic, Marin D; Winham, Stacey J; Bobo, William V; Geske, Jennifer; Seymour, Lisa R.; Mori, Nicole; Bond, David J.; Biernacka, Joanna M; Frye, Mark A.

In: Journal of Affective Disorders, Vol. 201, 01.09.2016, p. 95-98.

Research output: Contribution to journalArticle

McElroy, SL, Crow, S, Blom, TJ, Cuellar-Barboza, AB, Prieto, ML, Veldic, MD, Winham, SJ, Bobo, WV, Geske, J, Seymour, LR, Mori, N, Bond, DJ, Biernacka, JM & Frye, MA 2016, 'Clinical features of bipolar spectrum with binge eating behaviour', Journal of Affective Disorders, vol. 201, pp. 95-98. https://doi.org/10.1016/j.jad.2016.05.003
McElroy, Susan L. ; Crow, Scott ; Blom, Thomas J. ; Cuellar-Barboza, Alfredo B. ; Prieto, Miguel L. ; Veldic, Marin D ; Winham, Stacey J ; Bobo, William V ; Geske, Jennifer ; Seymour, Lisa R. ; Mori, Nicole ; Bond, David J. ; Biernacka, Joanna M ; Frye, Mark A. / Clinical features of bipolar spectrum with binge eating behaviour. In: Journal of Affective Disorders. 2016 ; Vol. 201. pp. 95-98.
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abstract = "Objective To determine whether bipolar spectrum disorder with binge eating behavior (BE) is an important clinical sub-phenotype. Methods Prevalence rates and correlates of different levels of BE were assessed in 1114 bipolar spectrum patients participating in a genetic biobank. BE and eating disorders (EDs) were assessed with the Eating Disorder Diagnostic Scale (EDDS). Psychiatric illness burden was evaluated with measures of suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. Medical illness burden was evaluated with body mass index (BMI) and the Cumulative Index Rating Scale (CIRS). Results Thirty percent of patients had any BE and 27{\%} had BE plus an ED diagnosis. Compared with bipolar spectrum patients without BE, bipolar spectrum patients with BE were younger and more likely to be female; had significantly higher levels of eating psychopathology, suicidality, mood instability, and anxiety disorder comorbidity; had a significantly higher mean BMI and a significantly higher rate of obesity; and had a significantly higher medical illness burden. Bipolar spectrum patients with BE but no ED diagnosis were more similar to bipolar spectrum patients without BE than to those with an ED. Nonetheless, the positive predictive value and specificity of BE predicting an ED was 0.90 and 0.96, respectively. Limitations As only two patients had co-occurring anorexia nervosa, these results may not generalize to bipolar spectrum patients with restricting EDs. Conclusion Bipolar spectrum disorder with broadly-defined BE may not be as clinically relevant a sub-phenotype as bipolar spectrum disorder with an ED but may be an adequate proxy for the latter when phenotyping large samples of individuals.",
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T1 - Clinical features of bipolar spectrum with binge eating behaviour

AU - McElroy, Susan L.

AU - Crow, Scott

AU - Blom, Thomas J.

AU - Cuellar-Barboza, Alfredo B.

AU - Prieto, Miguel L.

AU - Veldic, Marin D

AU - Winham, Stacey J

AU - Bobo, William V

AU - Geske, Jennifer

AU - Seymour, Lisa R.

AU - Mori, Nicole

AU - Bond, David J.

AU - Biernacka, Joanna M

AU - Frye, Mark A

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N2 - Objective To determine whether bipolar spectrum disorder with binge eating behavior (BE) is an important clinical sub-phenotype. Methods Prevalence rates and correlates of different levels of BE were assessed in 1114 bipolar spectrum patients participating in a genetic biobank. BE and eating disorders (EDs) were assessed with the Eating Disorder Diagnostic Scale (EDDS). Psychiatric illness burden was evaluated with measures of suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. Medical illness burden was evaluated with body mass index (BMI) and the Cumulative Index Rating Scale (CIRS). Results Thirty percent of patients had any BE and 27% had BE plus an ED diagnosis. Compared with bipolar spectrum patients without BE, bipolar spectrum patients with BE were younger and more likely to be female; had significantly higher levels of eating psychopathology, suicidality, mood instability, and anxiety disorder comorbidity; had a significantly higher mean BMI and a significantly higher rate of obesity; and had a significantly higher medical illness burden. Bipolar spectrum patients with BE but no ED diagnosis were more similar to bipolar spectrum patients without BE than to those with an ED. Nonetheless, the positive predictive value and specificity of BE predicting an ED was 0.90 and 0.96, respectively. Limitations As only two patients had co-occurring anorexia nervosa, these results may not generalize to bipolar spectrum patients with restricting EDs. Conclusion Bipolar spectrum disorder with broadly-defined BE may not be as clinically relevant a sub-phenotype as bipolar spectrum disorder with an ED but may be an adequate proxy for the latter when phenotyping large samples of individuals.

AB - Objective To determine whether bipolar spectrum disorder with binge eating behavior (BE) is an important clinical sub-phenotype. Methods Prevalence rates and correlates of different levels of BE were assessed in 1114 bipolar spectrum patients participating in a genetic biobank. BE and eating disorders (EDs) were assessed with the Eating Disorder Diagnostic Scale (EDDS). Psychiatric illness burden was evaluated with measures of suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. Medical illness burden was evaluated with body mass index (BMI) and the Cumulative Index Rating Scale (CIRS). Results Thirty percent of patients had any BE and 27% had BE plus an ED diagnosis. Compared with bipolar spectrum patients without BE, bipolar spectrum patients with BE were younger and more likely to be female; had significantly higher levels of eating psychopathology, suicidality, mood instability, and anxiety disorder comorbidity; had a significantly higher mean BMI and a significantly higher rate of obesity; and had a significantly higher medical illness burden. Bipolar spectrum patients with BE but no ED diagnosis were more similar to bipolar spectrum patients without BE than to those with an ED. Nonetheless, the positive predictive value and specificity of BE predicting an ED was 0.90 and 0.96, respectively. Limitations As only two patients had co-occurring anorexia nervosa, these results may not generalize to bipolar spectrum patients with restricting EDs. Conclusion Bipolar spectrum disorder with broadly-defined BE may not be as clinically relevant a sub-phenotype as bipolar spectrum disorder with an ED but may be an adequate proxy for the latter when phenotyping large samples of individuals.

KW - Binge eating

KW - Bipolar spectrum

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