Clinical phenotype and genetic risk factors for bipolar disorder with binge eating: an update

Alfredo B. Cuellar-Barboza, Stacey J. Winham, Joanna M. Biernacka, Mark A. Frye, Susan L. McElroy

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Introduction: Clinical and genetic study of psychiatric conditions has underscored the co-occurrence of complex phenotypes and the need to refine them. Bipolar Disorder (BD) and Binge Eating (BE) behavior are common psychiatric conditions that have high heritability and high co-occurrence, such that at least one quarter of BD patients have BE (BD + BE). Genetic studies of BD alone and of BE alone suggest complex polygenic risk models, with many genetic risk loci yet to be identified. Areas covered: We review studies of the epidemiology of BD+BE, its clinical features (cognitive traits, psychiatric comorbidity, and role of obesity), genomic studies (of BD, eating disorders (ED) defined by BE, and BD + BE), and therapeutic implications of BD + BE. Expert opinion: Subphenotyping of complex psychiatric disorders reduces heterogeneity and increases statistical power and effect size; thus, it enhances our capacity to find missing genetic (and other) risk factors. BD + BE has a severe clinical picture and genetic studies suggests a distinct genetic architecture. Differential therapeutic interventions may be needed for patients with BD + BE compared with BD patients without BE. Recognizing the BD + BE subphenotype is an example of moving towards more precise clinical and genetic entities.

Original languageEnglish (US)
Pages (from-to)867-879
Number of pages13
JournalExpert review of neurotherapeutics
Issue number9
StatePublished - Sep 2 2019


  • Bipolar
  • GWAS
  • binge eating
  • eating disorders
  • genetics

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)


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