Impaired glucose metabolism moderates the course of illness in bipolar disorder

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dc.contributor.author Mansur, Rodrigo Barbachan [UNIFESP]
dc.contributor.author Rizzo, Lucas Bortolotto [UNIFESP]
dc.contributor.author Santos, Camila Mauricio [UNIFESP]
dc.contributor.author Asevedo, Elson [UNIFESP]
dc.contributor.author Cunha, Graccielle Rodrigues da [UNIFESP]
dc.contributor.author Noto, Mariane Nunes [UNIFESP]
dc.contributor.author Pedrini, Mariana [UNIFESP]
dc.contributor.author Zeni, Maiara [UNIFESP]
dc.contributor.author Cordeiro, Quirino [UNIFESP]
dc.contributor.author McIntyre, Roger S.
dc.contributor.author Brietzke, Elisa [UNIFESP]
dc.date.accessioned 2020-07-22T13:23:05Z
dc.date.available 2020-07-22T13:23:05Z
dc.date.issued 2016
dc.identifier http://dx.doi.org/10.1016/j.jad.2016.02.002
dc.identifier.citation Journal Of Affective Disorders. Amsterdam, v. 195, p. 57-62, 2016.
dc.identifier.issn 0165-0327
dc.identifier.uri https://repositorio.unifesp.br/handle/11600/56029
dc.description.abstract Background: The longitudinal course of bipolar disorder (BD) is highly heterogeneous, and is moderated by the presence of general medical comorbidities. This study aimed to investigate the moderating effects of impaired glucose metabolism (IGM) on variables of illness course and severity in a BD population. Methods: Fifty-five patients with BD were evaluated. All subjects were evaluated with respect to current and past psychiatric and medical disorders, as well as lifetime use of any medication. Body mass index (BMI) and metabolic parameters were obtained. IGM was operationalized as pre-diabetes or type 2 diabetes mellitus. Results: Thirty (54.5%) individuals had IGM. After adjustment for age, gender, ethnicity, alcohol use, smoking, BMI and past and current exposure to psychotropic medications, individuals with IGM, when compared to euglycemic participants, had an earlier age of onset (RR: 0.835, p=0.024), longer illness duration (RR: 1.754, p=0.007), a higher number of previous manic/hypomanic episodes (RR: 1.483, p=0.002) and a higher ratio of manic/hypomanic to depressive episodes (RR: 1.753, p=0.028). Moreover, we observed a moderating effect of IGM on the association between number of mood episodes and other variables of illness course, with the correlation between lifetime mood episodes and frequency of episodes being significantly greater in the IGM subgroup (RR: 1.027, p=0.029). All associations observed herein remained significant after adjusting for relevant confounding factors (e.g. age, alcohol and tobacco use, exposure to psychotropic agents, BMI). Limitations: Cross-sectional design, small sample size. Conclusions: Comorbid IGM may be a key moderator of illness progression in BD. (C) 2016 Elsevier B.V. All rights reserved. en
dc.format.extent 57-62
dc.language.iso eng
dc.publisher Elsevier Science Bv
dc.relation.ispartof Journal Of Affective Disorders
dc.rights Acesso restrito
dc.subject Bipolar disorder en
dc.subject Course en
dc.subject Progression en
dc.subject Impaired glucose metabolism en
dc.subject Diabetes en
dc.title Impaired glucose metabolism moderates the course of illness in bipolar disorder en
dc.type Artigo
dc.description.affiliation Univ Fed Sao Paulo UNIFESP, Dept Psychiat, LINC, Sao Paulo, Brazil
dc.description.affiliation Univ Toronto, Univ Hlth Network, MDPU, Toronto, ON, Canada
dc.description.affiliation Univ Tubingen, Dept Psychiat, Clin Psychiat & Psychotherapy, Tubingen, Germany
dc.description.affiliation Vila Maria Outpatient Clin, Sao Paulo, Brazil
dc.description.affiliation ISCMSP, Dept Psychiat, Sao Paulo, Brazil
dc.description.affiliationUnifesp Univ Fed Sao Paulo UNIFESP, Dept Psychiat, LINC, Sao Paulo, Brazil
dc.identifier.doi 10.1016/j.jad.2016.02.002
dc.description.source Web of Science
dc.identifier.wos WOS:000371257400007
dc.coverage Amsterdam
dc.citation.volume 195



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