Association between history of psychosis and cardiovascular disease in bipolar disorder

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dc.contributor.authorPrieto, Miguel
dc.contributor.authorMcElroy, Susan
dc.contributor.authorHayes, Sharonne
dc.contributor.authorSutor, Bruce
dc.contributor.authorKung, Simon
dc.contributor.authorBobo, William
dc.contributor.authorFuentes, Manuel
dc.contributor.authorCuellar-Barboza, Alfredo
dc.contributor.authorCrow, Scott
dc.contributor.authorÖsby, Urban
dc.contributor.authorChauhan, Mohit
dc.contributor.authorWestman, Jeanette
dc.contributor.authorGeske, Jennifer
dc.contributor.authorColby, Colin
dc.contributor.authorRyu, Euijung
dc.contributor.authorBiernacka, Joanna
dc.contributor.authorFrye, Mark
dc.date.accessioned2016-05-23T16:53:34Z
dc.date.available2016-05-23T16:53:34Z
dc.date.issued2015
dc.description.abstractOBJECTIVES: 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.
dc.identifier.citationPrieto ML, McElroy SL, Hayes SN, Sutor B, Kung S, Bobo WV, Fuentes ME, Cuellar-Barboza AB, Crow S, Ösby U, Chauhan M, Westman J, Geske JR, Colby CL, Ryu E, Biernacka JM, Frye MA. Association between history of psychosis and cardiovascular disease in bipolar disorder. Bipolar Disord. 2015 Aug;17(5):518-27.
dc.identifier.urihttp://hdl.handle.net/11447/312
dc.identifier.urihttp://dx.doi.org/10.1111/bdi.12302
dc.language.isoen_US
dc.publisherJohn Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
dc.subjectBipolar disorder
dc.subjectCardiovascular diseases
dc.subjectHypertension
dc.subjectPhenotype
dc.subjectRisk
dc.titleAssociation between history of psychosis and cardiovascular disease in bipolar disorder
dc.typeArtículo

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