Review Paper Clinical Features of Bipolar Disorder With and Without Comorbid Diabetes

Objective: Several papers have reported higher prevalence of diabetes mellitus (DM) type 2 in patients suffering from bipolar disorder (BD). The possible links between these 2 dis-orders include treatment, lifestyle, alterations in signal transduction, and possibly, a genetic link. To study this relation more closely, we investigated whether there are any differences in the clinical characteristics of BD patients with and without DM. Method: We compared the clinical data of 26 diabetic and 196 nondiabetic subjects from The Maritime Bipolar Registry. Subjects were aged 15 to 82 years, with psychiatric diag-noses of BD I (n = 151), BD II (n = 65), and BD not otherwise specified (n = 6). The regis-try included basic demographic data and details on the clinical course of bipolar illness, its treatment, and physical comorbidity. In a subsequent analysis using logistic regression, we examined the variables showing differences between groups, with diabetes as an outcome variable. Results: The prevalence of DM in our sample was 11.7 % (n = 26). Diabetic patients were significantly older than nondiabetic patients (P < 0.001), had higher rates of rapid cycling (P = 0.02) and chronic course of BD (P = 0.006), scored lower on the Global Assessment of Functioning Scale (P = 0.01), were more often on disability for BD (P < 0.001), and had higher body mass index (P < 0.001) and increased frequency of hypertension (P = 0.003). Lifetime history of treatment with antipsychotics was not significantly associated with an elevated risk of diabetes (P = 0.16); however, the data showed a trend toward more fre-quent use of antipsychotic medication among diabetic subjects. Conclusions: Our findings suggest that the diagnosis of DM in BD patients is relevant for their prognosis and outcome. (Can J Psychiatry 2003;48:458–461) Information on funding and support and author affiliations appears at the end of the article