Course of bipolar illness worsens after onset of insulin resistance

J Psychiatr Res. 2018 Jul:102:34-37. doi: 10.1016/j.jpsychires.2018.03.006. Epub 2018 Mar 14.


Cross-sectional studies indicate that comorbid insulin resistance (IR) and type 2 diabetes are associated with a more severe course of bipolar disorder (BD); however, this relationship has not previously been assessed longitudinally. To address this, we reviewed health records of a case series of six patients with BD and comorbid IR. Severity and length of affective episodes (both mania and depression) over the lifetime were recorded using the Affective Morbidity Index; these data were obtained from ongoing prospective follow-up and from detailed retrospective chart reviews. All six patients with a previously episodic, relapsing-remitting course of illness experienced a worsening of morbidity after the onset of laboratory-demonstrated IR. These results suggest that IR may be a potential testable, modifiable factor in the progression of BD from a treatment responsive (episodic) to a non-responsive (chronic) course of illness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bipolar Disorder / epidemiology*
  • Bipolar Disorder / physiopathology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Disease Progression
  • Female
  • Humans
  • Insulin Resistance / physiology*
  • Male
  • Middle Aged
  • Morbidity
  • Retrospective Studies
  • Severity of Illness Index