Insulin resistance and outcome in bipolar disorder
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
Grant support
64410
Canadian Institutes of Health Research - Canada
PubMed
25323142
DOI
10.1192/bjp.bp.114.152850
PII: S0007125000237410
Knihovny.cz E-resources
- MeSH
- Antimanic Agents therapeutic use MeSH
- Bipolar Disorder blood complications drug therapy MeSH
- Diabetes Mellitus, Type 2 blood complications MeSH
- Adult MeSH
- Insulin blood MeSH
- Insulin Resistance * MeSH
- Blood Glucose metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Lithium therapeutic use MeSH
- Adolescent MeSH
- Young Adult MeSH
- Disease Progression MeSH
- Cross-Sectional Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Case-Control Studies MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Antimanic Agents MeSH
- Insulin MeSH
- Blood Glucose MeSH
- Lithium MeSH
BACKGROUND: Little is known about the impact of insulin resistance on bipolar disorder. AIMS: To examine the relationships between insulin resistance, type 2 diabetes and clinical course and treatment outcomes in bipolar disorder. METHOD: We 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. RESULTS: Patients 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. CONCLUSIONS: Comorbid insulin resistance may be an important factor in resistance to treatment in bipolar disorder.
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