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Awareness of Metabolic Concerns in Patients With Bipolar Disorder: A Survey of European Psychiatrists

Published online by Cambridge University Press:  21 December 2007

Michael Bauer*
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, D-01307Dresden, Germany
Yves Lecrubier
Affiliation:
INSERM U302, Hôpital de la Salpêtrière, 47 Boulevard de l'Hôpital 75013, Paris, France
Trisha Suppes
Affiliation:
Bipolar Research Program, Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX75390-9121, USA
*
Corresponding author. Tel.: +49 351 458 2772; fax: +49 351 458 4324. E-mail addresses: michael.bauer@uniklinikum-dresden.de (M. Bauer), lecru@ext.jussieu.fr (Y. Lecrubier), trisha.suppes@utsouthwestern.edu (T. Suppes).
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Abstract

Purpose.

An online survey of European psychiatrists assessed awareness of the metabolic syndrome and its influence on the management of bipolar disorder.

Materials and methods.

Psychiatrists in the United Kingdom, France, Germany, Spain, and Italy were surveyed from April to June 2006. Eligibility criteria w ere 4–30 years in practice, ≥50% of time in direct patient care, had seen ≥10 bipolar patients in the preceding month. Aggregate data were weighted to represent the practicing physician population per country.

Results.

of 718 respondents, 56% had diagnosed metabolic syndrome. Respondents reported that metabolic syndrome prevalence was higher in bipolar patients (25%) than in the general population (20%). Seventy-two percent felt that metabolic syndrome poses significant health risks, warranting monitoring/treatment, and were most concerned with the bipolar medication adverse effects of weight gain, cognitive impairment, and glucose intolerance. Survey respondents recognized clear differences among psychotropic agents in the propensity to induce metabolic adverse effects. Sixty-five percent of respondents indicated that they had made interviewing and monitoring changes in the past three years as a result of metabolic concerns.

Conclusions.

European psychiatrists view metabolic syndrome as highly prevalent in the general population and in bipolar patients; twothirds have changed their management of bipolar patients because of metabolic health concerns.

Type
Original article
Copyright
Copyright © European Psychiatric Association 2008

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Footnotes

1

Tel.: +1 214 648 6924; fax: +1 214 648 6922.

References

Alberti, G.Introduction to the metabolic syndrome. Eur Heart J 2005;7:D3D5.CrossRefGoogle Scholar
Aronne, L.J., Segal, K.R.Weight gain in the treatment of mood disorders. J Clin Psychiatry 2003;64(Suppl. 8):2229.Google ScholarPubMed
Balkau, B., Charles, M.A., Drivsholm, T., Borch-Johnsen, K., Wareham, N., Yudkin, J.S.et al.Frequency of the WHO metabolic syndrome in European cohorts, and an alternative definition of an insulin resistance syndrome. Diabetes Metab 2002;28:364376.Google Scholar
Basu, R., Brar, J.S., Chengappa, K.N., John, V., Parepally, H., Gershon, S.et al.The prevalence of the metabolic syndrome in patients with schizoaffective disorder – bipolar subtype. Bipolar Disord 2004;6:314318.CrossRefGoogle ScholarPubMed
Bosello, O., Zamboni, M.Visceral obesity and metabolic syndrome. Obes Rev 2000;1:4756.CrossRefGoogle ScholarPubMed
Bowden, C.L., Calabrese, J.R., McElroy, S.L., Gyulai, L., Wassef, A., Petty, F.et al.A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder Divalproex Maintenance Study Group Arch Gen Psychiatry. 2000;57:481489.CrossRefGoogle ScholarPubMed
Bowden, C.L., Calabrese, J.R., Sachs, G., Yatham, L.N., Asghar, S.A., Hompland, M.et al.A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Arch Gen Psychiatry 2003;60:392400.CrossRefGoogle ScholarPubMed
Cassidy, F., Ahearn, E., Carroll, B.J.Elevated frequency of diabetes mellitus in hospitalized manic-depressive patients. Am J Psychiatry 1999;156:14171420.Google ScholarPubMed
Citrome, L., Blonde, L., Damatarca, C.Metabolic issues in patients with severe mental illness. South Med J 2005;98:714720.CrossRefGoogle ScholarPubMed
Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. National Diabetes Data Group Diabetes 1979;28:10391057.Google Scholar
American Diabetes Association, The American Psychiatric Association, The American Association of Clinical Endocrinologists, The North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004;27:596601.CrossRefGoogle Scholar
World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. 1999;99.(2):166.Google Scholar
Deshmukh, R., Franco, K.Managing weight gain as a side effect of antidepressant therapy. Cleve Clin J Med 2003;70 614, 616, 618, passimCrossRefGoogle ScholarPubMed
Elmslie, J.L., Mann, J.I., Silverstone, J.T., Williams, S.M., Romans, S.E.Determinants of overweight and obesity in patients with bipolar disorder. J Clin Psychiatry 2001;62:486491.CrossRefGoogle ScholarPubMed
Fagiolini, A., Frank, E., Scott, J.A., Turkin, S., Kupfer, D.J.Metabolic syndrome in bipolar disorder: findings from the Bipolar Disorder Center for Pennsylvanians. Bipolar Disord 2005;7:424430.CrossRefGoogle ScholarPubMed
Fagiolini, A., Kupfer, D.J., Houck, P.R., Novick, D.M., Frank, E.Obesity as a correlate of outcome in patients with bipolar I disorder. Am J Psychiatry 2003;160:112117.CrossRefGoogle ScholarPubMed
Fava, M.Weight gain and antidepressants. J Clin Psychiatry 2000;61(Suppl. 11):3741.Google ScholarPubMed
Grant, B.F., Hasin, D.S., Chou, S.P., Stinson, F.S., Dawson, D.A.Nicotine dependence and psychiatric disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2004;61:11071115.CrossRefGoogle ScholarPubMed
Grundy, S.M., Cleeman, J.I., Daniels, S.R., Donato, K.A., Eckel, R.H., Franklin, B.A.et al.Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 2005;112:27352752.CrossRefGoogle ScholarPubMed
Hu, G., Qiao, Q., Tuomilehto, J., Balkau, B., Borch-Johnsen, K., Pyorala, K.Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med 2004;164:10661076.CrossRefGoogle ScholarPubMed
International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome; 2005.Google Scholar
Isomaa, B., Almgren, P., Tuomi, T., Forsen, B., Lahti, K., Nissen, M.et al.Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683689.CrossRefGoogle ScholarPubMed
Kalarchian, M.A., Marcus, M.D., Levine, M.D., Haas, G.L., Greeno, C.G., Weissfeld, L.A.et al.Behavioral treatment of obesity in patients taking antipsychotic medications. J Clin Psychiatry 2005;66:10581063.CrossRefGoogle ScholarPubMed
Keck, P.E., McElroy, S.L.Bipolar disorder, obesity, and pharmacotherapy-associated weight gain. J Clin Psychiatry 2003;64:14261435.CrossRefGoogle ScholarPubMed
Ketter, T.A., Haupt, D.W.Perceptions of weight gain and bipolar pharmacotherapy: results of a 2005 survey of physicians in clinical practice. Curr Med Res Opin 2006;22:23452353.CrossRefGoogle ScholarPubMed
Ketter, T.A., Kalali, A.H., Weisler, R.H.A 6-month, multicenter, open-label evaluation of beaded, extended-release carbamazepine capsule monotherapy in bipolar disorder patients with manic or mixed episodes. J Clin Psychiatry 2004;65:668673.CrossRefGoogle ScholarPubMed
Kilbourne, A.M., Cornelius, J.R., Han, X., Pincus, H.A., Shad, M., Salloum, I.et al.Burden of general medical conditions among individuals with bipolar disorder. Bipolar Disord 2004;6:368373.CrossRefGoogle ScholarPubMed
Kolotkin, R.L., Crosby, R.D., Corey-Lisle, P.K., Li, H., Swanson, J.M.Performance of a weight-related measure of quality of life in a psychiatric sample. Qual Life Res 2006;15:587596.Google Scholar
Kruger, S., Shugar, G., Cooke, R.G.Comorbidity of binge eating disorder and the partial binge eating syndrome with bipolar disorder. Int J Eat Disord 1996;19:4552.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Laaksonen, D.E., Lakka, H.M., Niskanen, L.K., Kaplan, G.A., Salonen, J.T., Lakka, T.A.Metabolic syndrome and development of diabetes mellitus: application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol 2002;156:10701077.CrossRefGoogle ScholarPubMed
Lakka, H.M., Laaksonen, D.E., Lakka, T.A., Niskanen, L.K., Kumpusalo, E., Tuomilehto, J.et al.The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. J Am Med Assoc 2002;288:27092716.CrossRefGoogle ScholarPubMed
Malhotra, S., McElroy, S.L.Associations between metabolic syndrome and psychiatric disorder. Prim Psychiatry 2003;10:3744.Google Scholar
Marken, P.A., Pies, R.W.Emerging treatments for bipolar disorder: safety and adverse effect profiles (CE) (February). Ann Pharmacother 2006;40:276285.CrossRefGoogle Scholar
McElroy, S.L., Frye, M.A., Suppes, T., Dhavale, D., Keck, P.E. Jr., Leverich, G.S.et al.Correlates of overweight and obesity in 644 patients with bipolar disorder. J Clin Psychiatry 2002;63:207213.CrossRefGoogle ScholarPubMed
McElroy, S.L., Kotwal, R., Keck, P.E. Jr., Akiskal, H.S.Comorbidity of bipolar and eating disorders: distinct or related disorders with shared dysregulations?. J Affect Disord 2005;86:107127.CrossRefGoogle ScholarPubMed
Morriss, R., Mohammed, F.A.Metabolism, lifestyle and bipolar affective disorder. J Psychopharmacol 2005;19:94101.Google ScholarPubMed
Ramacciotti, C.E., Paoli, R.A., Marcacci, G., Piccinni, A., Burgalassi, A., Dell'Osso, L.et al.Relationship between bipolar illness and binge-eating disorders. Psychiatry Res 2005;135:165170.CrossRefGoogle ScholarPubMed
Sachs, G., Bowden, C., Calabrese, J.R., Ketter, T., Thompson, T., White, R.et al.Effects of lamotrigine and lithium on body weight during maintenance treatment of bipolar I disorder. Bipolar Disord 2006;8:175181.Google ScholarPubMed
Saely, C.H., Aczel, S., Marte, T., Langer, P., Hoefle, G., Drexel, H.The metabolic syndrome, insulin resistance, and cardiovascular risk in diabetic and nondiabetic patients. J Clin Endocrinol Metab 2005;90:56985703.Google ScholarPubMed
Suppes, T., McElroy, S., Hirschfeld, R.Awareness of metabolic concerns in patients with bipolar disorder: a survey of 500 US psychiatrists. Psychopharmacol Bull 2007;40:2237.Google ScholarPubMed
Taylor, V., Macqueen, G.Associations between bipolar disorder and metabolic syndrome: a review. J Clin Psychiatry 2006;67:10341041.CrossRefGoogle ScholarPubMed
Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 2002;106:31403141.Google Scholar
Thompson, W.K., Kupfer, D.J., Fagiolini, A., Scott, J.A., Frank, E.Prevalence and clinical correlates of medical comorbidities in patients with bipolar I disorder: analysis of acute-phase data from a randomized controlled trial. J Clin Psychiatry 2006;67:783788.Google ScholarPubMed
Vornik, L.A., Brown, E.S.Management of comorbid bipolar disorder and substance abuse. J Clin Psychiatry 2006;67(Suppl. 7):2430.Google ScholarPubMed
Wildes, J.E., Marcus, M.D., Fagiolini, A.Obesity in patients with bipolar disorder: a biopsychosocial–behavioral model. J Clin Psychiatry 2006;67:904915.CrossRefGoogle ScholarPubMed
Yusuf, S., Hawken, S., Ounpuu, S., Bautista, L., Franzosi, M.G., Commerford, P.et al.Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case–control study. Lancet 2005;366:16401649.CrossRefGoogle ScholarPubMed
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