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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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1
Department of Psychiatry and Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

OBJECTIVE:

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.

METHODS:

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).

RESULTS:

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.

CONCLUSION:

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.

KEYWORDS:

Bipolar disorder; Hypercholesterolemia; Hyperglycemia; Obesity

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