Bipolar disorder and metabolic syndrome

The metabolic syndrome encompasses a group of metabolic risk factors that are associated with an increased risk of diabetes, heart disease, heart attacks and stroke. Several definitions have been proposed but the consensus is that the presence of any three out of impaired glucose metabolism or insulin resistance, high-blood pressure, high cholesterol and abdominal obesity is diagnostic of metabolic syndrome. Rates of metabolic syndrome have been reported at 30% in bipolar-disorder sufferers and bipolar disorder has also been linked with increased risk for obesity, diabetes and high cholesterol. A study of 718 psychiatrists from all over Europe was aimed at assessing the awareness of metabolic issues among European psychiatrists and how this awareness influenced their management of bipolar disorder. 56% of the sample had diagnosed metabolic syndrome in their patients. Respondents reported that metabolic syndrome was higher among bipolar patients (25%) than in the general population (20%). 72% felt that metabolic syndrome poses significant health risks warranting monitoring and treatment and the psychiatrists were most concerned about the medication side effects of weight gain, cognitive impairment and glucose intolerance. The participants recognised clear differences among drugs in terms of their propensity to cause weight gain and 65% of them indicated that they had made interviewing and monitoring changes in the past three years as a result of metabolic concerns.

Bauer, Michael, Lecrubier, Yves and Suppes, Trisha - Awareness of metabolic concerns in patients with bipolar disorder: a survey of European psychiatrists European Psychiatry 2008, 23, 169-177