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Bulimic behavior in euthymic bipolar disorder patients

Published online by Cambridge University Press:  26 August 2025

M. Abdelkefi*
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
S. Ellouze
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
R. Jbir
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
W. Abid
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
N. Bouattour
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
N. Halouani
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
M. Turki
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
J. Aloulou
Affiliation:
Psychiatry B, Hedi Chaker university hospital, Sfax, Tunisia
*
*Corresponding author.

Abstract

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Introduction

Bulimic behavior has been increasingly recognized in patients with bipolar disorder (BD). Even during euthymic phases, individuals with BD may remain vulnerable to disordered eating patterns such as bulimia and binge eating.

Objectives

This study aims to examine the occurrence of bulimic behavior in euthymic patients with BD and identify associated clinical and sociodemographic factors.

Methods

We conducted a cross-sectional, descriptive, and analytical study of 93 patients followed for bipolar disorder at the psychiatry outpatient unit at the Hedi Chaker University Hospital in Sfax. The questionnaire included sociodemographic data, medical and psychiatric history, and anthropometric characteristics. Bulimic behavior was assessed using the Bulimic Investigatory Test Edinburgh (BITE).

Results

The mean age of the participants was 41.49±12.33 years, with a M/F sex ratio of 2.58. Among the patients, 58.1% were married, 45.2% had secondary education, and 47.3% were unemployed. Personal somatic history was reported by 35.5%, while 11.8% had psychiatric comorbidities in addition to bipolar disorder.

The mean body mass index (BMI) was 27.4 kg/m² (SD=5.96), with 29% of patients being overweight and 31.2% classified as obese.

Eight patients (8.6%) had BITE scores above the threshold of 20, indicating bulimic behavior.

Significant associations were found between elevated BITE scores and female gender (p=0.012), comorbid medical conditions (p=0.005), family history of schizophrenia (p=0.024), weight (p<10⁻³), BMI (p<10⁻³), hypomanic residual symptoms (p<10⁻³), irregular follow-up (p=0.027), and delayed management of BD (p=0.04).

Conclusions

Our results highlight the importance of early identification and comprehensive management of disordered eating in bipolar patients, even during periods of mood stability, to optimize overall health and psychiatric outcomes.

Disclosure of Interest

None Declared

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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