Review article
Comorbidity of eating disorders in patients with bipolar affective disorder

The research performed so far has indicated high indexes of co-morbidity in patients with bipolar affective disorder (BD) especially for psychoactive substance disorders, anxiety disorders and disorders with associated impulse control, including eating disorders. The prevalence of eating disorders such as anorexia nervosa (AN), bulimia nervosa (BN), and particularly that of binge eating disorder (BED) in patients with BD is significantly higher than in the general population. Numerous clinical similarities between BD and eating disorders have been indicated. The onset of the symptoms of both diseases usually occurs during adolescence or early adulthood. Cyclicality in the course of illness is visible, expressed in frequent changes of the clinical picture between anorexia and bulimia in eating disorders and between depression and hypomania/mania in BD. In both disorders there are common neurobiological mechanisms, with particular importance of the hypothalamic-pituitary-adrenal axis and dysregulation in the serotonergic system. In both BD and eating disorders we observe the presence of eating irregularities, fluctuations in body mass as well as the tendency to impulsive behaviour. There are many scales for the evaluation of patients with eating disorders; however, none of them so far has allowed a detailed assessment of eating abnormalities in patients with bipolar disorder. The Barcelona Bipolar Eating Disorder Scale (BEDS) introduced by the research team in Barcelona led by Eduard Vieta, the Polish version of which was verified at the Department of Adult Psychiatry, Poznan University of Medical Sciences, is a useful instrument to detect a co-morbidity between BD and eating disorders and also to identify patients with a potential risk of significant weight gain during treatment and to select for them the most appropriate medications.