Background/Purpose: Frequency of psychiatric disorders in BD is a debated issue: while some experts attribute their presence to the chronicity of the illness, others think that they may be imputable to disease activity or to intrinsic features of the disease. The primary aims were to determine the frequency of psychiatric disorders in BD patients, both with neurological involvement or without; the secondary aims were: to investigate a possible association between disease activity/organ involvement and psychiatric profile of the BD patients and to compare the distribution of psychiatric disorders of patients with BD with those in patients with other chronic diseases.

Methods: One hundred and twenty BD patients with a diagnosis of BD according the ISG criteria were studied. Demographic profile of the cohort studied are summarized in Table 1. Psychiatric disorders evaluated were: bipolar disorder, obsessive-compulsive disorder, depression and sleep disorder. Age and sex matched disease controls of systemic lupus erythematosus (SLE) and chronic arterial hypertension were included. BD disease activity was evaluated by means of BD current activity form 2006 and clinician’s overall perception of disease activity.

Results: Prevalence of psychiatric disorders are shown in Table 2. No correlations were found between the presence of psychiatric disorders and disease activity; specifically either BD patients with an activity index ≤ 7 and ≥ 8 were equally characterized by a high prevalence of psychiatric disorders. Moreover, the occurrence of psychiatric disorders did not result correlating with a specific organ involvement. Comparing the frequency of bipolar disorder with the disease controls, the results have shown a significant difference in favor of bipolar disorder in BD (p < 0.001).

 Table 1. Demographic profile.

	Neuro- BD	BD without neurological involvement
Number of patients	46	64
M/F	38/8	42/22
Mean age ± SD (min-max) (years)	43±7 (15-68)	42±8 (18-71)
Mean disease duration ± SD (min-max) (years)	9±2 (3-28)	10±2 (4-28)

Table 2. Prevalence of psychiatric disorders

psychiatric disorders	Neuro- BD n (%)	BD without neurological involvement n (%)
bipolar disorder	41 (65)	28 (64)
obsessive-compulsive disorder	29 (46)	20 (43)
depression	20 (32)	16 (36)
sleep disorder	5 (11)	10 (16)

Conclusion: Our results show a high frequency of psychiatric disorders in BD patients. This elevated prevalence both in BD patient with or without neurological involvement, independently from disease activity and significantly than in disease controls, strongly suggest that psychiatric disorders may represent a primary feature of BD.

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