Impact of metabolic syndrome and clinical features on functioning in patients with bipolar disorder: a cross-sectional study

High persistence and low treatment rates of metabolic syndrome in patients with mood and anxiety disorders: A naturalistic follow-up study

BACKGROUND

Patients with affective and anxiety disorders are at risk of metabolic syndrome (MetS) and, consequently, cardiovascular disease and premature death. In this study, the course and treatment of MetS was investigated using longitudinal data from a naturalistic sample of affective- and anxiety-disordered outpatients (Monitoring Outcome of psychiatric PHARmacotherapy [MOPHAR]).

METHODS

Demographics, clinical characteristics, medication use, and MetS components were obtained for n = 2098 patients at baseline and, in a FU-subsample of n = 507 patients, after a median follow-up (FU) of 11 months. Furthermore, pharmacological treatment rates of MetS were investigated at baseline and FU. Finally, demographic and clinical determinants of change in MetS (component) scores were investigated.

RESULTS

At baseline, 34.6 % of n = 2098 patients had MetS, 41.4 % of whom received treatment. Of patients with persisting MetS, 46.1 % received treatment for one (or more) MetS component(s) at baseline, and 56.6 % received treatment at FU. Treatment rates of solely elevated blood pressure and reduced HDL-cholesterol did significantly, but modestly, improve. Higher age, male sex, smoking behavior, low education, diabetes, and depressive versus anxiety disorder were predictors of worse outcome at FU on at least one MetS component.

LIMITATIONS

We did not have data on lifestyle interventions as a form of treatment, which might partly have explained the observed low pharmacotherapeutic treatment rates.

CONCLUSION

MetS (components) show high persistence rates in affective- and anxiety-disordered patients, and are, despite adequate monitoring, undertreated over time. This indicates that adherence and implementation of monitoring protocols should be crucially improved in psychiatric outpatients in secondary care.

A Systematic Review and Meta-Analysis of Metabolic Syndrome Prevalence in Chinese Inpatients with Bipolar Disorder

The aim of the work was to study the prevalence of metabolic syndrome in Chinese patients with bipolar disorder. We searched Chinese literature related to the study in prevalence of metabolic syndrome in bipolar disorder in Chinese language, among which results such as comments, letters, reviews and case reports were excluded. The prevalence of metabolic syndrome in bipolar disorder was researched and discussed. A total of 1562 subjects were included in 11 studies. The prevalence of MetS in bipolar disorder was 33% (95% CI=0.29-0.37), which was higher significantly than normal control (10.82%), but similar to schizophrenia (31.59%). The 41.41% prevalence of MetS in male patients was higher significantly than that in females (26.83%).The prevalence of MetS in BD treated by AAP was 47.54%, by MS was 19.19%, by MS+AAP was 40%.The prevalence of MetS in BD treated by carbamazepine was 28.21%, by lithium was 30%, by valproate was 21.71%, by clozepine was 51.43%, by olanzapine was 39.84%, by quetiapine was 39.44%, and by risperidone was 35%. The prevalence of MetS in bipolar disorder was 33% (95% CI=0.29-0.37), which was higher significantly than normal control (10.82%), but similar to schizophrenia (31.59%). AAP and MS were the main one risks of MetS in BD.