CME Article

Cardiometabolic Health in Bipolar Disorder

David E. Kemp, MD, MS

  • Psychiatric Annals
  • May 2012 - Volume 42 · Issue 5: 179-183
  • DOI: 10.3928/00485713-20120507-05
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Abstract

CME Educational Objectives

  1. Describe the shared pathophysiology that contributes to the development of both bipolar disorder and cardiometabolic disease.

  2. Recognize genetic variants that increase risk for antipsychotic-induced weight gain and type 2 diabetes.

  3. Describe treatment strategies that target physical or cardiometabolic health as a means of improving psychiatric outcomes.

Although bipolar disorder is characterized by adverse effects on mood and social functioning, it is also associated with poor physical health. Some of the most prevalent comorbidities affecting individuals with bipolar disorder include those of a cardiometabolic nature, such as obesity, insulin resistance, and cardiovascular disease.1,2 In addition to detracting from physical well-being, there is growing awareness that comorbid medical conditions in people with bipolar disorder contribute to poorer psychiatric treatment outcomes and are associated with more severe mood symptoms.3–5 These comorbid conditions may arise from overlapping biological pathways that promote the development of both mood dysregulation and altered metabolism. In this article, the scope of cardiometabolic health concerns in bipolar disorder will be reviewed, including the prevalence of modifiable risk factors, pathophysiological correlates linking metabolic dysregulation and mood, and potential genetic vulnerabilities that contribute to the development of cardiometabolic illness and mood disorders. Novel treatment approaches that target improvement of metabolic health as a means of improving mood, cognition, and other psychiatric symptoms will also be discussed.

AUTHORS

David E. Kemp, MD, MS, is Assistant Professor of Psychiatry, and Director, Mood & Metabolic Clinic, Case Western Reserve University, and University Hospitals Case Medical Center, Department of Psychiatry, Cleveland, OH, USA. Jinbo Fan, PhD, is Assistant Professor, Department of Epidemiology and Biostatistics and Department of Psychiatry, Case Western Reserve University, School of Medicine, Department of Epidemiology and Biostatistics, Cleveland, OH.

Disclosure: Dr. Kemp, within the past 12 months, has acted as a consultant to Bristol-Myers Squibb and Janssen and has served on the speaker’s bureau for AstraZeneca and Pfizer. His spouse has been a minor shareholder of Abbott and Sanofi within the past 12 months. Dr. Fan has no disclosures to report.

Address correspondence to: David E. Kemp, MD, MS, 10524 Euclid Avenue, 12th Floor, Cleveland, OH 44106; fax 216-844-2875; email: .kemp.david@gmail.com

doi: 10.3928/00485713-20120507-05

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