Author:
Calkin Cynthia V.,Ruzickova Martina,Uher Rudolf,Hajek Tomas,Slaney Claire M.,Garnham Julie S.,O'Donovan M. Claire,Alda Martin
Abstract
BackgroundLittle is known about the impact of insulin resistance on bipolar
disorder.AimsTo examine the relationships between insulin resistance, type 2 diabetes
and clinical course and treatment outcomes in bipolar disorder.MethodWe measured fasting glucose and insulin in 121 adults with bipolar
disorder. We diagnosed type 2 diabetes and determined insulin resistance.
The National Institute of Mental Health Life Chart was used to record the
course of bipolar disorder and the Alda scale to establish response to
prophylactic lithium treatment.ResultsPatients with bipolar disorder and type 2 diabetes or insulin resistance
had three times higher odds of a chronic course of bipolar disorder
compared with euglycaemic patients (50% and 48.7% respectively
v. 27.3%, odds ratio (OR) = 3.07, P
= 0.007), three times higher odds of rapid cycling (38.5% and 39.5%
respectively v. 18.2%, OR = 3.13, P =
0.012) and were more likely to be refractory to lithium treatment (36.8%
and 36.7% respectively v. 3.2%, OR = 8.40,
P<0.0001). All associations remained significant
after controlling for antipsychotic exposure and body mass index in
sensitivity analyses.ConclusionsComorbid insulin resistance may be an important factor in resistance to
treatment in bipolar disorder.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
117 articles.
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