University of Pisa, Pisa, Italy.
Barcelona Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Bipolar Disord. 2017 Sep;19(6):458-464. doi: 10.1111/bdi.12519. Epub 2017 Jul 10.
The Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-Mix study aimed to estimate the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions. The present post-hoc analysis evaluated the association between obesity and the presence of mixed features and bipolarity.
A total of 2811 MDE subjects were enrolled in a multicenter cross-sectional study. In 2744 patients, the body mass index (BMI) was evaluated. Psychiatric symptoms, and sociodemographic and clinical variables were collected, comparing the characteristics of MDE patients with (MDE-OB) and without (MDE-NOB) obesity.
Obesity (BMI ≥30) was registered in 493 patients (18%). In the MDE-OB group, 90 patients (20%) fulfilled the DSM-IV-TR criteria for bipolar disease (BD), 225 patients (50%) fulfilled the bipolarity specifier criteria, 59 patients (13%) fulfilled DSM-5 criteria for MDEs with mixed features, and 226 patients (50%) fulfilled Research-Based Diagnostic Criteria for an MDE. Older age, history of (hypo)manic switches during antidepressant treatment, the occurrence of three or more MDEs, atypical depressive features, antipsychotic treatment, female gender, depressive mixed state according to DSM-5 criteria, comorbid eating disorders, and anxiety disorders were significantly associated with the MDE-OB group. Among (hypo)manic symptoms during the current MDE, psychomotor agitation, distractibility, increased energy, and risky behaviors were the variables most frequently associated with MDE-OB group.
In our sample, the presence of obesity in patients with an MDE seemed to be associated with higher rates of bipolar spectrum disorders. These findings suggest that obesity in patients with an MDE could be considered as a possible marker of bipolarity.
双相障碍：提高诊断、指导和教育（BRIDGE）-II-Mix 研究旨在根据不同定义估计重性抑郁发作（MDE）患者混合状态的频率。本事后分析评估了肥胖与混合特征和双相性的存在之间的关系。
共纳入 2811 例 MDE 受试者进行多中心横断面研究。在 2744 例患者中，评估了体重指数（BMI）。收集了精神症状以及社会人口学和临床变量，并比较了肥胖（BMI≥30）和非肥胖（MDE-NOB）MDE 患者的特征。
493 例患者（18%）登记为肥胖。在 MDE-OB 组中，90 例（20%）符合 DSM-IV-TR 双相障碍（BD）标准，225 例（50%）符合双相性特定标准，59 例（13%）符合 DSM-5 混合特征 MDE 标准，226 例（50%）符合 MDE 研究诊断标准。年龄较大、抗抑郁治疗期间（低）躁狂发作史、出现 3 次或更多次 MDE、非典型抑郁特征、抗精神病药物治疗、女性、DSM-5 标准下的抑郁混合状态、共病饮食障碍和焦虑障碍与 MDE-OB 组显著相关。在当前 MDE 期间（低）躁狂症状中，精神运动激越、注意力不集中、精力增加和冒险行为是与 MDE-OB 组最相关的变量。
在我们的样本中，MDE 患者肥胖的存在似乎与较高的双相谱系障碍发生率相关。这些发现表明，MDE 患者肥胖可能被视为双相性的一个可能标志物。
