Cognitive Neuropsychiatry Lab, Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.
Cognitive Neuropsychiatry Lab, Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.
J Affect Disord. 2019 Dec 1;259:228-243. doi: 10.1016/j.jad.2019.08.070. Epub 2019 Aug 20.
Individuals with bipolar disorder (BD) have an increased risk of developing eating disorders (ED) or disordered eating symptoms compared to the general population. Eating pathology characterised by binge and/or purge symptomatology are the most common to develop in BD, yet the underlying aetiological mechanisms are relatively unknown. Theoretical models of BD-ED comorbidity suggest that shared pathophysiological factors, including emotion dysregulation and impulsivity may contribute to the development of binge/purge eating pathology in BD.
A systematic search was conducted to assess two research questions: 1. What are the prevalence or incidence rates of different ED in BD? 2. Are clinical correlates hallmarked by emotion dysregulation and/or impulsivity (alcohol/substance use disorders, mood instability and suicidality) significantly elevated in BD with ED (BD-ED) groups compared to BD only?
Any type of lifetime or current ED ranged from 1.9% to 33.3% in BD. Type of BD diagnosis did not appear to significantly impact likelihood of ED development. Alcohol use disorder, mood instability and suicidality were significantly higher in BD-ED compared to BD only.
Potential biases within the selected studies; impacting generalisability of results and comparability between studies. Varying treatment interventions (including medications) may confound results and comparability between studies. Assessment of binge eating varied, also limiting comparability.
Eating pathology may occur comorbidly with BD due to shared underlying pathophysiological features. This could have significant implications for future interventions; both psychopharmacological and psychotherapeutic. More comprehensive investigations are required to identify the functionality of dysregulated emotion and impulsivity in the development of eating pathology in BD.
与普通人群相比，双相情感障碍（BD）患者出现饮食障碍（ED）或饮食障碍症状的风险增加。以暴食和/或清除症状为特征的进食病理是 BD 中最常见的，但潜在的病因机制尚不清楚。BD-ED 共病的理论模型表明，包括情绪调节障碍和冲动在内的共享病理生理因素可能导致 BD 中暴食/清除性进食障碍的发展。
进行了系统搜索，以评估两个研究问题：1. 不同 ED 在 BD 中的患病率或发病率是多少？2. 与仅 BD 相比，BD-ED 组中是否存在以情绪调节障碍和/或冲动为标志的临床相关性（酒精/物质使用障碍、情绪不稳定和自杀意念）显著升高？
BD 中的任何类型的终生或当前 ED 发生率从 1.9%到 33.3%不等。BD 诊断类型似乎并未显著影响 ED 发展的可能性。与仅 BD 相比，BD-ED 中的酒精使用障碍、情绪不稳定和自杀意念显著升高。
所选研究中存在潜在偏差；影响结果的普遍性和研究之间的可比性。不同的治疗干预措施（包括药物治疗）可能会混淆结果和研究之间的可比性。暴食的评估各不相同，也限制了可比性。
由于潜在的病理生理特征共享，饮食障碍可能与 BD 共病。这可能对未来的干预措施（包括精神药理学和心理治疗）产生重大影响。需要更全面的调查来确定情绪调节障碍和冲动在 BD 中进食障碍发展中的功能。
