mental and behavioral patients to the primary health clinics [12]. As per the Global Asthma Report, about 8.6% of young adults (age 18–45) experienced the symptoms of asthma in 2014, whereas comorbid asthma was seen in a higher proportion of bipolar patients (12.5%) in our study [13]. Hypothyroidism was seen in 8.1% bipolar patients in our study population, which was two times higher than that seen in the general US population (4.6%) as per the recent report by the Endocrine Society [14]. Bipolar disorder has been found to have strong affiliations with thyroid dysfunction, whether the interaction of lithium is considered or not [15,16]. Previous studies have provided evidence linking hypothyroidism with bipolar disorder, with a notable association with manic relapse [17] and rapid cycling bipolar disorder [18]. Our data results also showed an increased association of thyroid dysfunction with bipolar disorder. Hypothyroidism was the third most common medical comorbidity in bipolar patients. Also, females with bipolar disorder in this study had a three-fold higher likelihood of comorbid hypothyroidism compared to males. Migraines also had a remarkable association in females with bipolar disease in our study; they were three times more likely to have migraines as a comorbidity than males.
