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Preliminary Findings Regarding Overweight and Obesity in Pediatric Bipolar Disorder

Benjamin I. Goldstein, MD, PhD; Boris Birmaher, MD; David A. Axelson, MD; Tina R. Goldstein, PhD; Christianne Esposito-Smythers, PhD; Michael A. Strober, PhD; Jeffrey Hunt, MD; Henrietta Leonard, MD† ; Mary Kay Gill, RN, MSN; Satish Iyengar, PhD; Colleen Grimm, BA; Mei Yang, MSc; Neal D. Ryan, MD; and Martin B. Keller, MD

Published: December 31, 2008

Article Abstract

Objective: Overweight/obesity is highly prevalent among adults with bipolar disorder and has been associated with illness severity. Little is known regarding overweight/obesity among youth with bipolar disorder.

Method: Subjects were 348 youths aged 7 to 17 years who met DSM-IV criteria for bipolar I or bipolar II disorder or study-operationalized criteria for bipolar disorder not otherwise specified and were enrolled in the Course and Outcome of Bipolar Illness in Youth study. Age- and sex-adjusted body mass index was computed according to International Obesity Task Force cut points, based on self- and parent-reported height and weight, to determine overweight/obesity. The study was conducted from October 2000 to July 2006.

Results: Overweight/obesity was prevalent among 42% of subjects. The most robust predictors of overweight/obesity in a logistic regression model were younger age, nonwhite race, lifetime physical abuse, substance use disorders, psychiatric hospitalizations, and exposure to >= 2 medication classes associated with weight gain.

Conclusions: The prevalence of overweight/obesity among youth with bipolar disorder may be modestly greater than in the general population. Moreover, similar to adults, overweight/obesity among youth with bipolar disorder may be associated with increased psychiatric burden. These preliminary findings underscore the importance of early identification of overweight/obesity among youth with bipolar disorder. Future studies are needed to clarify the direction of the associations between overweight/obesity and the identified predictors and to compare the prevalence of overweight/obesity among youth with bipolar disorder versus other psychiatric disorders.

Volume: 69

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