Comorbid Eating Disorders in a Sample of Youth With Bipolar Disorder: Elevated Burden of Dimensional and Categorical Psychopathology.

Diana Khoubaeva, Mikaela K. Dimick, J. Roane, Vanessa H. Timmins, Rachel H. B. Mitchell, B. Goldstein
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引用次数: 5

Abstract

Objective: There is growing recognition of the importance of comorbid eating disorders (ED) among individuals with bipolar disorder (BD). However, most studies on this topic have focused on adult samples, and little is known regarding comorbid ED among youth with BD. Methods: The sample included 197 youth with DSM-IV BD (BD-I, BD-II, or BD-NOS [not otherwise specified]), aged 13-20 years and recruited from a subspecialized clinic within a tertiary academic health sciences center from 2009 to 2017. Univariate analyses examined demographic and clinical variables among participants with versus without lifetime DSM-IV ED. Variables significant at P < .10 were entered into a backward stepwise regression. Results: Fifty-six participants (28.4%) had lifetime DSM-IV ED (3.6% anorexia nervosa, 8.1% bulimia nervosa, 16.8% ED not otherwise specified). Significant correlates of lifetime ED were female sex (P < .001), BD-II subtype (P = .03), suicidal ideation (P = .006), suicide attempts (P = .004), non-suicidal self-injury (P < .001), sexual abuse (P = .02), cigarette smoking (P = .001), anxiety disorders (P = .004), posttraumatic stress disorder (P = .004), substance use disorders (P = .006), history of individual therapy (P = .01), and family history of anxiety (P = .01). Significant correlates of no lifetime ED were BD-I subtype (P < .001) and lifetime lithium use (P = .01). The ED group had significantly more severe lifetime depression (P < .001) and significantly more self-reported affective lability (P < .001) and borderline personality traits (P < .001). In multivariate analysis, the most robust predictors of lifetime ED were female sex (odds ratio [OR] = 4.61, P = .004), BD-I subtype (OR = 0.21, P = .03), cigarette smoking (OR = 2.78, P = .02), individual therapy (OR = 3.92, P = .03), family history of anxiety (OR = 2.86, P = .02), and borderline personality traits (OR = 1.01, P = .009). Conclusions: ED are common among youth with BD and associated with adverse clinical characteristics, many of which converge with prior adult literature. Future studies evaluating specific ED subtypes are warranted, as are treatment studies targeting comorbid ED in youth with BD.
双相情感障碍青年的共病性饮食失调:维度和分类精神病理学负担增加。
目的:人们越来越认识到双相情感障碍(BD)患者共病性饮食障碍(ED)的重要性。然而,关于这一主题的大多数研究都集中在成人样本上,很少有人知道青年BD患者的共病性ED。方法:样本包括197名患有DSM-IV BD (BD- i, BD- ii或BD- nos[未另有说明])的青年,年龄13-20岁,从2009年至2017年在三级学术卫生科学中心的亚专科诊所招募。单因素分析检查了患有与不患有终身DSM-IV ED的参与者的人口学和临床变量。10个进行逐步回归分析。结果:56名参与者(28.4%)终生患有DSM-IV版ED(神经性厌食症3.6%,神经性贪食8.1%,其他未列明ED 16.8%)。终生ED的显著相关因素为女性(P < 0.001)、BD-II亚型(P = 0.03)、自杀意念(P = 0.006)、自杀未遂(P = 0.004)、非自杀性自伤(P < 0.001)、性虐待(P = 0.02)、吸烟(P = 0.001)、焦虑症(P = 0.004)、创伤后应激障碍(P = 0.004)、物质使用障碍(P = 0.006)、个体治疗史(P = 0.01)、焦虑家族史(P = 0.01)。无终身ED的显著相关因素是BD-I亚型(P < 0.001)和终身锂使用(P = 0.01)。ED组有更严重的终生抑郁(P < 0.001),自我报告的情感不稳定(P < 0.001)和边缘型人格特征(P < 0.001)。在多因素分析中,终生ED最可靠的预测因素是女性(优势比[OR] = 4.61, P = 0.004)、BD-I型(OR = 0.21, P = 0.03)、吸烟(OR = 2.78, P = 0.02)、个体治疗(OR = 3.92, P = 0.03)、焦虑家族史(OR = 2.86, P = 0.02)和边缘性人格特质(OR = 1.01, P = 0.009)。结论:ED在青年双相障碍患者中很常见,并伴有不良临床特征,其中许多与先前的成人文献一致。未来评估特定ED亚型的研究是有必要的,针对青年双相障碍患者共病ED的治疗研究也是有必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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