Spanish Consensus on Physical Health of Patients with Bipolar Disorder

Background and objective: Patients with bipolar disorder have much higher physical morbidity and mortality rates than the general population. In addition to a higher mortality rate from suicide, these patients also have a higher prevalence of physical disorders. The aim of this consensus, promoted by the Spanish Societies of Psychiatry and Biological Psychiatry in collaboration with the General Practitioners Societies, was to establish practical recommendations on procedures for detection, prevention and intervention in the somatic diseases that coexist with bipolar disorder in order to improve the quality of life and life expectancy of these patients. Method: The Spanish Societies of Psychiatry and Biological Psychiatry designated a scientific committee that selected 32 expert psychiatrists and 10 experts from other medical specialties. Working groups were formed for each specialty for the purpose of adapting the guidelines applied in the general population to patients with bipolar disorder. A systematic review of medical comorbidity and mortality in these patients was carried out and two multidisciplinary consensus meetings were held. Results: The literature review revealed an increased risk of hypertension, obesity, smoking, pulmonary diseases, migraine and HIV infection among patients with bipolar disorder. There was also evidence of higher mortality rates from cardiovascular and respiratory diseases and infections, as well as from suicide. The expert group reached a consensus on a series of basic measures to detect medical comorbidity applicable to the monitoring of these patients. The resulting recommendations will be accepted and disseminated by the promoting societies. Conclusions: The recommendations generated by the Spanish Consensus on the Physical Health of Patients with Bipolar disorder include the most important aspects for the improvement of the psychosocial functioning, quality of life and life expectancy of these patients. (C) 2008 Sociedad Espanola de Psiquiatria y Sociedad Espanola de Psiquiatria Biologica.