Association between history of psychosis and cardiovascular disease in bipolar disorder.
Bipolar Disord
; 17(5): 518-27, 2015 Aug.
Article
em En
| MEDLINE
| ID: mdl-26062406
ABSTRACT
OBJECTIVES:
To determine whether clinical features of bipolar disorder, such as history of psychosis, and cardiovascular disease (CVD) risk factors contribute to a higher risk of CVD among patients with bipolar disorder.METHODS:
This cross-sectional study included a sample of 988 patients with bipolar I or bipolar II disorder or schizoaffective bipolar type confirmed by the Structured Clinical Interview for DSM-IV-TR disorders (SCID). Medical comorbidity burden was quantified utilizing the Cumulative Illness Severity Rating Scale (CIRS). This 13-item organ-based scale includes cardiac disease severity quantification. Confirmed by medical record review, patients who scored 1 (current mild or past significant problem) or higher in the cardiac item were compared by logistic regression to patients who scored 0 (no impairment), adjusting for CVD risk factors that were selected using a backwards stepwise approach or were obtained from the literature.RESULTS:
In a multivariate model, age [odds ratio (OR) = 3.03, 95% confidence interval (CI) 1.66-5.54, p < 0.0001], hypertension (OR = 2.43, 95% CI 1.69-3.55, p < 0.0001), and history of psychosis (OR = 1.48, 95% CI 1.03-2.13, p = 0.03) were associated with CVD. When CVD risk factors from the literature were added to the analysis, age (OR = 3.19, 95% CI 1.67-6.10, p = 0.0005) and hypertension (OR = 2.46, 95% CI 1.61-3.76, p < 0.01) remained significant, with psychosis being at the trend level (OR = 1.43, 95% CI 0.96-2.13, p = 0.08).CONCLUSIONS:
The phenotype of psychotic bipolar disorder may reflect higher illness severity with associated cardiac comorbidity. Further studies are encouraged to clarify the effect of the disease burden (i.e., depression), lifestyle, and treatment interventions (i.e., atypical antipsychotics) on this risk association.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos Psicóticos
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Transtorno Bipolar
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Doenças Cardiovasculares
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Bipolar Disord
Assunto da revista:
PSIQUIATRIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos