{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:43:03Z","timestamp":1787013783672,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,3,7]],"date-time":"2013-03-07T00:00:00Z","timestamp":1362614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined general medical illnesses and their association with clinical features of bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Data were cross\u2010sectional and derived from the Lithium Treatment \u2013 Moderate Dose Use Study (Li\n                      <jats:styled-content style=\"fixed-case\">TMUS<\/jats:styled-content>\n                      ), which randomized symptomatic adults (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0264 with available medical comorbidity scores) with bipolar disorder to moderate doses of lithium plus optimized treatment (\n                      <jats:styled-content style=\"fixed-case\">OPT<\/jats:styled-content>\n                      ) or to\n                      <jats:styled-content style=\"fixed-case\">OPT<\/jats:styled-content>\n                      alone. Clinically significant high and low medical comorbidity burden were defined as a Cumulative Illness Rating Scale (\n                      <jats:styled-content style=\"fixed-case\">CIRS<\/jats:styled-content>\n                      ) score \u22654 and &lt;4 respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The baseline prevalence of significant medical comorbidity was 53% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0139). Patients with high medical burden were more likely to present in a major depressive episode (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.04), meet criteria for obsessive\u2013compulsive disorder (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.02), and experience a greater number of lifetime mood episodes (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.02). They were also more likely to be prescribed a greater number of psychotropic medications (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.002). Sixty\u2010nine per\u00a0cent of the sample was overweight or obese as defined by body mass index (\n                      <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n                      ), with African Americans representing the racial group with the highest proportion of stage\n                      <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\n                      obesity (\n                      <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n                      \u226535; 31%,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The burden of comorbid medical illnesses was high in this generalizable sample of treatment\u2010seeking patients and appears associated with worsened course of illness and psychotropic medication patterns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.12101","type":"journal-article","created":{"date-parts":[[2013,3,7]],"date-time":"2013-03-07T02:44:26Z","timestamp":1362624266000},"page":"24-34","source":"Crossref","is-referenced-by-count":77,"title":["General medical burden in bipolar disorder: findings from the Li\n                    <scp>TMUS<\/scp>\n                    comparative effectiveness trial"],"prefix":"10.1111","volume":"129","author":[{"given":"D. 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