Physical disorders

This category covers common co-occurring physical disorders including diabetes, metabolic syndrome, and heart disease.

Asthma

What is asthma? Asthma has been initially believed to be a disorder of inflammation. In asthmatic patients, inflammatory cytokines are altered with asthma exacerbation. People with bipolar disorder are also found to have dysfunction of inflammation during various emotional states. As such, some researchers suggest that these two disorders may share similar mechanisms in their pathophysiology. What is the evidence for the co-occurrence of asthma and bipolar disorder? Moderate to high quality evidence suggests a small increased risk of bipolar disorder in people with asthma than in healthy controls. Lower quality evidence also found a small increased risk of asthma…

Blood disorders

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Cancer

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Cerebrovascular disease

How is cerebrovascular disease related to bipolar disorder? People with bipolar disorder may show increased rates of co-occurring conditions when compared to general population rates. Cerebrovascular disease includes strokes, transient ischemic attacks, aneurysms, and vascular malformations. A stroke happens when blood flow to the brain is interrupted due to a blocked artery (ischaemic stroke) or when an artery bursts (haemorrhagic stroke). A transient ischemic attack is similar to a stroke, but less severe, and an aneurysm involves an enlarged artery caused by weakness in the arterial wall. These can all cause brain damage if cells do not get enough of…

Dementia

What is dementia? Dementia is characterised by significant cognitive impairment. Symptoms include memory impairment, aphasia (impaired language functioning), apraxia (aberrant movement), agnosia (inability to identify objects, people, sound or smell), and impaired executive functioning (for example, the ability to think abstractly, plan, initiate or stop actions). Other symptoms include behavioural disturbances, anxiety, apathy, delirium, and mood and sleep disturbances. Bipolar disorder is also often associated with cognitive and functional decline however, people with dementia show greater cognitive impairment. What is the evidence for dementia in people with bipolar disorder? Moderate to low quality evidence suggests a medium-sized increased risk of…

Diabetes

How is diabetes related to bipolar disorder? People with bipolar disorder may show increased rates of unrelated co-occurring illnesses, one example is diabetes. Diabetes is a state of impaired insulin function, either as a result of reduced insulin production (type I diabetes) or reduced insulin responsiveness (type II diabetes). Insulin regulates blood glucose levels, and reduced insulin function effectively increases blood glucose levels (hyperglycaemia). This is a dangerous state in the long term, and can ultimately damage the retina, kidneys, nerves and blood vessels. Consequently, effective management of diabetes is crucial. It is unclear if any increased risk in people…

Epilepsy

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Fibromyalgia

How is fibromyalgia related to bipolar disorder? People with bipolar disorder often have increased rates of co-occurring disorders, including fibromyalgia. Fibromyalgia is a centralised pain syndrome characterised by the presence of chronic widespread pain in association with fatigue, sleep disturbances and cognitive dysfunction. Fibromyalgia in people with bipolar disorder has been associated with higher rates of mood recurrences and greater disability. The use of antidepressants in fibromyalgia management may promote manic switches and episodes with mixed features, complicating the progressive course of bipolar disorder. What is the evidence for comorbid fibromyalgia? Moderate quality evidence suggests the overall prevalence of bipolar…

Heart disease

How is heart disease related to bipolar disorder? People with bipolar disorder show increased rates of co-occurring conditions. Heart disease is a common co-occurring disorder. It is unclear if the increased risk of heart disease is a consequence of the metabolic impact of medications or unhealthy lifestyle choices, or most likely, a combination of both. What is the evidence for heart disease in people with bipolar disorder? Moderate quality evidence suggests small increased risks of cardiovascular disease, congestive heart failure, and death due to cardiovascular disease in people with bipolar disorder compared to people without bipolar disorder. These findings were…

Infectious diseases

How are infectious diseases related to bipolar disorder? Infectious diseases include the human immunodeficiency virus infection (HIV), and hepatitis viruses, such as hepatitis B and hepatitis C. People with severe mental illness, including bipolar disorder, may be at increased risk of these diseases when compared to the general population. What is the evidence on infectious diseases in people with bipolar disorder? Moderate to low quality evidence suggests the prevalence rate of HIV in people with any severe mental illness, including bipolar disorder, is around 8%. For hepatitis B it is around 16%, and for hepatitis C it is around 7%….

Irritable bowel syndrome

How is irritable bowel syndrome related to bipolar disorder? People with bipolar disorder often have increased rates of co-occurring disorders, including irritable bowel syndrome. Irritable bowel syndrome is characterised by abdominal pain, bloating, and disturbances in bowel habits, without significant organic causes. Some people with irritable bowel syndrome also have bloody stools, weight loss, and fever. There is currently no consensus regarding clinical presentations, diagnosis, management or pathophysiology of irritable bowel syndrome. What is the evidence for irritable bowel syndrome? High quality evidence suggests a medium-sized increased rate of bipolar disorder in people with irritable bowel syndrome compared to people…

Metabolic syndrome

How is metabolic syndrome related to bipolar disorder? People with bipolar disorder often have increased rates of co-occurring disorders, including metabolic syndrome. Metabolic syndrome is defined by a clustering of at least three interrelated abnormalities including abdominal obesity, hyperglycemia, hypertension, high triglycerides, or low high-density lipoprotein (HDL) cholesterol levels. Metabolic syndrome increases the risk of diabetes and heart disease. What is the evidence for comorbid metabolic syndrome? Moderate to high quality evidence suggests the overall prevalence of metabolic syndrome in people with bipolar disorder is around 37%. Rates were highest in New Zealand, Australia and North America, in people treated…

Multiple sclerosis

How is multiple sclerosis related to bipolar disorder? People with bipolar disorder often have increased rates of co-occurring disorders, including multiple sclerosis. Multiple sclerosis is a disorder of the central nervous system, which disrupts nerve impulses in the brain, spinal cord and optic nerves. Symptoms include fatigue, motor dysfunction, incontinence or constipation, fatigue and psychological symptoms. What is the evidence for comorbid multiple sclerosis? Moderate to low quality evidence suggests the prevalence of bipolar disorder in people with multiple sclerosis is ~6%, although this rate was based on one study conducted in England, so may not be applicable to other…

Musculoskeletal and connective tissues

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Obesity

How is obesity related to bipolar disorder? Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), which is a person’s weight divided by the square of his or her height. A person with a BMI of 30 or more on metric measures is generally considered obese. Being obese is a major risk factor for diabetes, cardiovascular diseases and cancer. People with a severe mental illness are at increased risk of obesity, which may be due to genetic and/or socio-economic factors, lifestyle choices,…

Osteoporosis

What is osteoporosis? Osteoporosis is a progressive, systemic metabolic bone disorder, which results in lowered bone mineral density and increases an individual’s risk of fracture. Between ages 25 to 35 years, the skeletal structure reaches maturity and bone mass reaches its peak. After 40 years, the bone remodeling process serves to repair areas of damage in the bone. Naturally with increasing age and menopause, the process of bone resorption may be faster than the process of bone formation, leading to osteoporosis. However, other diseases and drugs may also induce osteoporosis. Many people with bipolar disorder are prescribed medications that can…

Pain

How is pain related to bipolar disorder? People with bipolar disorder often have increased rates of co-occurring disorders, including chronic pain and migraine. Pain has a deleterious impact on an individual’s health and wellbeing. Chronic pain in particular is associated with reduced quality of life and difficulties with activities of daily living and often has a negative impact on an individual’s emotional and mental health. What is the evidence for pain in people with bipolar disorder? Moderate quality evidence suggests the overall prevalence of migraine in people with bipolar disorder is ~35%. Rates were higher in people with bipolar II…

Peripheral vascular disease

How is peripheral vascular disease related to bipolar disorder? People with bipolar disorder show increased rates of co-occurring conditions. Peripheral vascular disease involves reduced circulation of blood to a body part other than the brain or heart, usually the legs or kidneys, and less commonly the arms. The main cause of peripheral vascular disease is a build-up of fatty deposits that narrow blood vessels and reduce circulation of blood to the associated body part. What is the evidence for peripheral vascular disease in people with bipolar disorder? Moderate quality evidence suggests a medium-sized increase in peripheral vascular disease in people…

Premenstrual syndrome

How is premenstrual syndrome related to bipolar disorder? Premenstrual syndrome involves emotional and behavioural symptoms that occur during the five days before menses for at least three menstrual cycles in a row. At least one affective and one somatic symptom must be present. Affective symptoms include depression, angry outbursts, irritability, anxiety, confusion, and social withdrawal. Somatic symptoms include breast tenderness, abdominal bloating, headache and swelling of extremities. Women with bipolar disorder and premenstrual syndrome may experience exacerbation of mood symptoms during the premenstrual phase. What is the evidence for premenstrual syndrome in women with bipolar disorder? Moderate quality evidence suggests…

Sleep apnea

How is sleep apnea related to bipolar disorder? People with bipolar disorder may show increased rates of co-occurring conditions including sleep apnea. The most common form of sleep apnea is obstructive sleep apnea (OSA), which occurs when the muscles of the upper airway relax in such a way that they block the airway during sleep. As a result, OSA is associated with daytime sleepiness, cognitive dysfunction, and the development of hypertension, cardiovascular disease, and abnormalities in glucose metabolism. OSA also has adverse effects on quality of life, and can lead to anxiety and depression symptoms. What is the evidence for…

Thyroid disorders

How are thyroid disorders related to bipolar disorder? People with bipolar disorder may show increased rates of co-occurring conditions, including thyroid disorders. The thyroid gland makes hormones that help control many of the body’s metabolic processes, such as heart rate, blood pressure, body temperature and weight. If the thyroid becomes deregulated (overactive or underactive), or cancerous, this can result in a range of physical symptoms, as well as depression. What is the evidence for thyroid disorders in people with bipolar disorder? Low quality evidence is unclear of the prevalence of thyroid disorders in people with bipolar disorder. Review authors suggest…

Visual impairment

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Wilson’s disease

How is Wilson’s disease related to bipolar disorder? Wilson’s disease is rare disorder that prevents the body from eliminating copper. It is caused by mutations in a gene that results in an accumulation of the metal in the liver, central nervous system, kidneys and other organs. Wilson’s disease usually presents in childhood, but sometimes in adolescence or young adulthood, and may be accompanied by psychiatric symptoms. What is the evidence for Wilson’s disease and bipolar disorder? Moderate to low quality evidence suggests an increased risk of bipolar disorder, and to a lesser extent, major depressive disorder, in people with Wilson’s…

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Title Colour Legend:
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Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.