Eating Disorders Fairly Common in Individuals with Bipolar Disorder

Many individuals who suffer from one mental illness suffer from other mental illnesses as well. For instance, a new research study indicates that nearly 15% of individuals who have Bipolar Disorder also suffer from eating disorders. Given that the treatment of individuals with co-occurring mental illnesses differs from treatment of individuals with a single mental illness, these results could have clinically significant implications.

Dr. Susan L. McElroy at the University of Cincinnati College of Medicine lead the study. She and her colleagues recruited 875 outpatient individuals suffering from Bipolar I or II disorder to participate in the study, which was aimed to assess the prevalence of eating disorders among this specific population. Each participant was interviewed by a clinician in order to evaluate bipolar and eating disorders. Additionally, the participants filled out questionnaires. The clinicians assessed participants for the eating disorders: anorexia nervosa, binge eating disorder, and bulimia nervosa. Other factors examined included: the individual's psychiatric history, including rapid cycling, past suicide attempts, and the age of symptom onset, demographic information, and family psychiatric history.

The average age of the 875 participants in the study was 41.1 years old and fifty-six percent of the individuals were female.

The researchers discovered that 14.2% of the participants had at least one eating disorder. More specifically, seventy-seven participants had binge eating disorder, 42 suffered from bulimia nervosa, and 27 had anorexia nervosa. The researchers also discovered there were no differences in the rate of eating disorders among individuals with bipolar I versus bipolar II disorder.

Women in this study suffered from eating disorders more often than men. Additionally, individuals who suffered from eating disorders and bipolar disorder tended to possess a more severe course of bipolar disorder than those who did not, evidenced by more rapid cycling, more prior episodes, more suicide attempts, and more mixed episodes. Furthermore, individuals who suffered from eating disorders in addition to bipolar disorder were more likely to possess a family history of mood disorders and substance abuse, were more likely to be obese or more severely obese, and tended to possess a higher body mass index (BMI) than participants who did not have eating disorders.

Dr. McElroy asserted, "Substantial clinical and community data indicate that bipolar disorder co-occurs with substance use, anxiety, and impulse control disorders, and that these comorbidities are associated with negative effects on the course, outcome, and treatment response of bipolar disorder. Another comorbidity, which has received far less systematic attention but which may also be important is that between bipolar disorder and eating disorders." Further research should examine how effective treatment for bipolar disorder is when an individual also suffers from an eating disorder. Additionally, the best treatments for individuals suffering from bipolar and eating disorders should be explored in order to ensure these individuals get the best care possible.

Bipolar disorder is constituted by, "highs," and, "lows," known medically as manic and depressive episodes, respectively. During a manic episode, an individual experiences an abnormally and persistently irritable, elevated, or expansive mood. This mood lasts for one week in duration or longer, and an individual experiences at least three of the of the following symptoms: psychomotor aggitation or an increase in goal-oriented behavior (such as at work, school, or socially), grandiosity or an inflated sense of self-esteem, excessive involvement in activities that are pleasureable, but may have painful consequences (e.g., shopping sprees or sexual indescressions), needs less sleep, is easily distracted, , and feels pressure to keep talking or is more talkative than usual.

An individual who is experiencing a major depressive episode will experience some or all of the following symptoms: depressed mood nearly everyday for most of the day, sleeping difficulties, weight gain or weight loss/changes in appetite, noticeable psychomotor retardation or aggitation, feeelings of inappropriate or excessive guilt, feelings of worthlessness, suicidal thoughts, decreased interest or pleasure in activities, difficulty concentrating, and/or fatigue. Depressive episodes are experienced for two weeks or longer.

Anorexia nervosa is constituted by a refusal to maintain minimal body weight for one's height and is accomplished through self-starvation. Bulimia nervosa entails a cycle of binge eating and purging behavior. Binge eating is defined by eating significantly more than others would given the same circumstances while puring entails utilizing inappropriate compensatory behaviors, such as exercising, using laxatives, enemas, or diet pills, self-induced vomiting, and periods of self-starvation in order to try to counteract binge eating. Finally, an individual suffering from binge eating disorder regularly eats unhealthily large amounts of food, according to Mayo Clinic.

If you are interested in learning more about the study discussed here, you may visit the Journal of Affective Disorders where this study was published on-line on July 31. Perhaps future research will be able to determine the best course of treatment for individuals suffering from both bipolar disorder and an eating disorder.

Sources:

BehaveNet: Clinical Capsule: DSM-IV & DSM-IV-TR: Manic Episode:
http://www.behavenet.com/capsules/disorders/manicep.htm

Bipolar Disorder Today: Major Depressive Episode: DSM-IV Criteria:
http://www.mental-health-today.com/bp/dep.htm

Mayo Clinic: Binge Eating Disorder: Definition:
http://www.mayoclinic.com/health/binge-eating-disorder/DS00608

Psych Central: High Rate of Eating Disorders in Bipolar Patients:
http://psychcentral.com/news/2010/08/05/high-rate-of-eating-disorders-in-bipolar-patients/16424.html