ESPECTRA: Searching the Bipolar Spectrum in Eating Disorder patients

Abstract Background Bipolar Disorder (BD) is a chronic, recurrent and highly prevalent illness. Despite the need for correct diagnosis to allow proper treatment, studies have shown that reaching a diagnosis can take up to ten years due to the lack of recognition of the broader presentations of BD. Frequent comorbidities with other psychiatric disorders are a major cause of misdiagnosis and warrant thorough evaluation. Methods/Design ESPECTRA (Occurrence of Bipolar Spectrum Disorders in Eating Disorder Patients) is a single-site cross-sectional study involving a comparison group, designed to evaluate the prevalence of bipolar spectrum in an eating disorder sample. Women aged 18-45 years will be evaluated using the SCID-P and Zurich criteria for diagnosis and the HAM-D, YOUNG, SCI-MOODS, HCL-32, BIS-11, BSQ, WHOQoL and EAS instruments for rating symptoms and measuring clinical correlates. Discussion The classificatory systems in psychiatry are based on categorical models that have been criticized for simplifying the diagnosis and leading to an increase in comorbidities. Some dimensional approaches have been proposed aimed at improving the validity and reliability of psychiatric disorder assessments, especially in conditions with high rates of comorbidity such as BD and Eating Disorder (ED). The Bipolar Spectrum (BS) remains under-recognized in clinical practice and its definition is not well established in current diagnostic guidelines. Broader evaluation of psychiatric disorders combining categorical and dimensional views could contribute to a more realistic understanding of comorbidities and help toward establishing a prognosis.

The authors would like to thank Prof Dr Doris Hupfeld Morenoa for her critical comments and Domingos Junior Rodrigues dos Santosa, Rogeria Oliveira Taraganob, Sabrina Camposb and Magda Costab for acquisition of data.

The authors would like to thank Prof Dr Doris Hupfeld Morenoa for her critical comments and Domingos Junior Rodrigues dos Santosa, Rogeria Oliveira Taraganob, Sabrina Camposb and Magda Costab for acquisition of data.

a Mood Disorders Unit (GRUDA). Department and Institute of Psychiatry, Clinicas Hospital, University of Sao Paulo, School of Medicine, Brazil.

a- Mood Disorders Unit (GRUDA). Department and Institute of Psychiatry, Clinicas Hospital, University of Sao Paulo, School of Medicine, Brazil.

b Eating Disorders Unit (AMBULIM) Department and Institute of Psychiatry, Clinicas Hospital, University of Sao Paulo, School of Medicine, Brazil

b- Eating Disorders Unit (AMBULIM) - Department and Institute of Psychiatry, Clinicas Hospital, University of Sao Paulo, School of Medicine, Brazil

Source of funding: support for this study was provided in the form of grants from the Department & Institute of Psychiatry University of São Paulo School of Medicine.

Source of funding: support for this study was provided in the form of grants from the Department & Institute of Psychiatry - University of São Paulo School of Medicine.

RNC, JA, TAC and RAM report no other sources of funding.

RNC, JA, TAC and RAM report no other sources of funding.