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Psychiatry Investig. 2009 Jun;6(2):78-84. doi: 10.4306/pi.2009.6.2.78. Epub 2009 Jun 30.

Correlates of metabolic abnormalities in bipolar I disorder at initiation of acute phase treatment.

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Department of Psychiatry and Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.



Treatment of bipolar patients is often complicated by metabolic abnormalities such as obesity, diabetes, and dyslipidemia. We therefore evaluated the prevalence of these abnormalities and their correlates, in bipolar I patients, at the time of commencement of pharmacological treatment for acute mood episodes.


The study cohort consisted of 184 bipolar I patients hospitalized for treatment of acute mood episodes. Socio-demographic and clinical variables were noted and metabolic parameters, including body mass index, fasting plasma glucose, fasting total cholesterol, and current treatment(s) for diabetes and/or dyslipidemia were measured before initiating medication(s).


Fifty-six (30.4%) subjects met our criteria for obesity; 80 (43.5%) had hyperglycemia, with 8 (4.3%) receiving anti-diabetic medication; and 38 (20.7%) had hypercholesterolemia, with 2 (1.1%) receiving cholesterol-lowering agents. We found that male sex (chi(2)=5.359, p=0.021), depressed or mixed state versus manic state (chi(2)=4.302, p=0.038), and duration of illness (t=2.756, p=0.006) were significantly associated with obesity. Older age (t=3.668, p<0.001), later age of disease onset (t=2.271, p=0.024), and lower level of educational attainment (beta=-0.531, p=0.001) were associated with hyperglycemia.


Our finding that metabolic abnormalities are prevalent when initiating acute pharmacological treatment in bipolar I patients indicates that these factors should be integrated into treatment plans at the onset of disease management.


Bipolar disorder; Hypercholesterolemia; Hyperglycemia; Obesity

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