Introduction: Bipolar disorder (BD) and asthma are leading causes of morbidity in the US and frequently co-occur. Objectives: We evaluated the clinical features and comorbidities of patients with BD and a history of asthma. Methods: In a cross-sectional analysis from the Mayo Clinic Bipolar Biobank, we explored the clinical characteristics of the BD and an asthma phenotype and fitted a multivariable regression model to identify risk factors for asthma. Results: A total of 721 individuals with BD were included. From these, 140 (19%) had a history of asthma. In a multivariable model only sex and evening chronotype were significant predictors of asthma with the odds ratios and 95% confidence intervals being 1.65 (1.00, 2.72; p=0.05) and 1.99 (1.25, 3.17; p < 0.01), respectively. Individuals with asthma had higher odds of having other medical comorbidities after adjusting for age, sex, and site including hypertension (OR = 2.29 (95% CI 1.42, 3.71); p < 0.01), fibromyalgia (2.29 (1.16, 4.51); p=0.02), obstructive sleep apnea (2.03 (1.18, 3.50); p=0.01), migraine (1.98 (1.31, 3.00); p < 0.01), osteoarthritis (2.08 (1.20, 3.61); p < 0.01), and COPD (2.80 (1.14, 6.84); p=0.02). Finally, individuals currently on lithium were less likely to have a history of asthma (0.48 (0.32, 0.71); p < 0.01). Conclusion: A history of asthma is common among patients with BD and is associated with being female and having an evening chronotype, as well as with increased odds of having other medical comorbidities. A lower likelihood of a history of asthma among those currently on lithium is an intriguing finding with potential clinical implications that warrants further study.
Bibliographical noteFunding Information:
This study was funded by the J. Willard and Alice S. Marriott Foundation . The sponsor did not have a role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
Notwithstanding the evidence supporting a strong and consistent association between asthma and BD, the clinical profile of individuals with BD and a history of asthma remains unclear. The aim of this study was to evaluate the clinical characteristics of individuals with BD with and without a history of asthma and explore clinical correlations between asthma and BD using data from a large and well-characterized sample of patients with BD from the Mayo Clinic Bipolar Biobank.The participants in this analysis were enrolled in The Mayo Clinic Bipolar Disorder Biobank (Frye et al., 2015). The Biobank's main entry criteria were: a diagnosis of bipolar I disorder (BD- I), bipolar II disorder (BD- II), or schizoaffective disorder - bipolar type (SAD-BD), as current evidence does not support SAD-BD as a discrete entity separate from BD (Allardyce et al., 2018; Cardno and Owen, 2014; Cosgrove and Suppes, 2013; Green et al., 2017); 18–80 years of age, inclusive; and no psychosis or current suicidal ideation (Frye et al., 2015). The Institutional Review Board at each of the four study sites, one in Mexico (Site 1: Universidad Autonoma de Nuevo Leon), one in Chile (Site 2: Universidad de los Andes), and two in the USA (Site 3: Mayo Clinic and Site 4: the Lindner Center of HOPE/University of Cincinnati) reviewed and approved the protocol. All participants provided written informed consent for inclusion into the Biobank.This study was funded by the J. Willard and Alice S. Marriott Foundation. The sponsor did not have a role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
- Bipolar disorder
- Sleep apnea