Emotional Hyper-Reactivity and Cardiometabolic Risk in Remitted Bipolar Disorder

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Patients with vs without emotional hyper-activity had significantly higher levels of fasting glucose, high-sensitivity C-reactive protein, and systolic and diastolic blood pressure.
Patients with vs without emotional hyper-activity had significantly higher levels of fasting glucose, high-sensitivity C-reactive protein, and systolic and diastolic blood pressure.

Patients with remitted bipolar disorder and emotional hyper-reactivity also have significantly higher levels of low-grade inflammation, hypertension, and impaired glucose metabolism, indicating a higher risk for cardiometabolic dysfunction, according to a study published in Acta Psychiatrica Scandinavica.

From January 2010 to June 2015, the study recruited 635 adult outpatients with bipolar disorder from the French Network of Bipolar Expert Centers, which integrates clinical practice with research for the use of community psychiatric care centers. Overall, 58.9% (n=374) of the study participants were women, and the cohort's mean age was 41.2±12.4 years. 

In total, 306 of the study participants had emotional hyper-reactivity, and after adjustments, these patients had significantly higher levels of fasting glucose, high-sensitivity C-reactive protein, systolic and diastolic blood pressure, and glycated hemoglobin than patients without emotional hyper-reactivity. They also showed a higher number of suicide attempts.

The strongest predictors of emotional hyper-activity in patients with bipolar disorder were fasting glucose, C-reactive protein, blood pressure, and number of suicide attempts. Using this predictive model, study investigators were able to identify patients with emotional hyper-reactivity with a 84.9% accuracy.

The study findings indicate that there may be a difference between the level of cardiometabolic risk for patients with remitted bipolar disorder and emotional hyper-reactivity. The researchers conclude that “preventive and therapeutic approaches should therefore go beyond stabilizing mood to include complementary brain-body interventions for reducing cardiometabolic risk, perhaps through psychoeducation and lifestyle-related interventions, including effective emotional reactivity management.”

Reference

Dargél AA, Roussel F, Volant S, et al. Emotional hyper‐reactivity and cardiometabolic risk in remitted bipolar patients: a machine learning approach [published online May 15, 2018]. Acta Psychiatr Scand. doi: 10.1111/acps.12901

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