Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Research article

Metabolic syndrome among psychiatric outpatients with mood and anxiety disorders

Published in: BMC Psychiatry | Issue 1/2014

Login to get access

Abstract

Background

Few studies have simultaneously compared the impacts of pharmacotherapy and mental diagnoses on metabolic syndrome (MetS) among psychiatric outpatients with mood and anxiety disorders. This study aimed to investigate the impacts of pharmacotherapy and mental diagnoses on MetS and the prevalence of MetS among these patients.

Methods

Two-hundred and twenty-nine outpatients (men/women = 85/144) were enrolled from 1147 outpatients with mood and anxiety disorders by systematic sampling. Psychiatric disorders and MetS were diagnosed using the Structured Clinical Interview for DSM-IV-TR and the new International Diabetics Federation definition, respectively. The numbers of antipsychotics, mood stabilizers, and antidepressants being taken were recorded. Logistic regression was used to investigate the impacts of pharmacotherapy and psychiatric diagnoses on MetS.

Results

Among 229 subjects, 51 (22.3%) fulfilled the criteria for MetS. The prevalence of MetS was highest in the bipolar I disorder (46.7%) patients, followed by bipolar II disorder (25.0%), major depressive disorder (22.0%), anxiety-only disorders (16.7%), and no mood and/or anxiety disorders (14.3%). The percentages of MetS among the five categories were correlated with those of the patients being treated with antipsychotics and mood stabilizers. Use of antipsychotics and/or mood stabilizers independently predicted a higher risk of MetS after controlling for demographic variables and psychiatric diagnoses. When adding body mass index (BMI) as an independent variable in the regression model, BMI became the most significant factor to predict MetS.

Conclusion

BMI was found to be an important factor related to MetS. Pharmacotherapy might be one of underlying causes of elevated BMI. The interactions among MetS, BMI, pharmacotherapy, and psychiatric diagnoses might need further research.
Appendix
Available only for authorised users
Literature
1.
Alberti KG, Zimmet P, Shaw J: Metabolic syndrome-a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006, 23: 469-480.CrossRefPubMed
2.
Wang Y, Yu Q, Chen Y, Cao F: Pathophysiology and therapeutics of cardiovascular disease in metabolic syndrome. Curr Pharm Des. 2013, 19: 4799-4805.CrossRefPubMed
3.
Singh RB, Gupta S, Dherange P, De Meester F, Wilczynska A, Alam SE, Pella D, Wilson DW: Metabolic syndrome: a brain disease. Can J Physiol Pharmacol. 2012, 90: 1171-1183.CrossRefPubMed
4.
Chang HH, Chou CH, Chen PS, Gean PW, Huang HC, Lin CY, Yang YK, Lu RB: High prevalence of metabolic disturbances in patients with bipolar disorder in Taiwan. J Affect Disord. 2009, 117: 124-129.CrossRefPubMed
5.
McElroy SL, Keck PE: Metabolic syndrome in bipolar disorder: a review with a focus on bipolar depression. J Clin Psychiatry. 2014, 75: 46-61.CrossRefPubMed
6.
Chadda RK, Ramshankar P, Deb KS, Sood M: Metabolic syndrome in schizophrenia: differences between antipsychotic-naive and treated patients. J Pharmacol Pharmacother. 2013, 4: 176-186.CrossRefPubMedPubMedCentral
7.
Malhotra N, Kulhara P, Chakrabarti S, Grover S: A prospective, longitudinal study of metabolic syndrome in patients with bipolar disorder and schizophrenia. J Affect Disord. 2013, 150: 653-658.CrossRefPubMed
8.
Kim B, Kim SJ, Son JI, Joo YH: Weight change in the acute treatment of bipolar I disorder: a naturalistic observational study of psychiatric inpatients. J Affect Disord. 2008, 105: 45-52.CrossRefPubMed
9.
Al-Zoairy R, Ress C, Tschoner A, Kaser S, Ebenbichler C: The effects of psychotropic drugs on the regulation of glucose metabolism. Curr Diabetes Rev. 2013, 9: 362-370.CrossRefPubMed
10.
Hasnain M, Vieweg WV: Weight considerations in psychotropic drug prescribing and switching. Postgrad Med. 2013, 125: 117-129.CrossRefPubMed
11.
van Winkel R, van Os J, Celic I: Psychiatric diagnosis as an independent risk factor for metabolic disturbances: results from a comprehensive, naturalistic screening program. J Clin Psychiatry. 2008, 69: 1319-1327.CrossRefPubMed
12.
Taylor V, MacQueen G: Associations between bipolar disorder and metabolic syndrome: a review. J Clin Psychiatry. 2006, 67: 1034-1041.CrossRefPubMed
13.
McIntyre RS, Rasgon NL, Kemp DE, Nguyen HT, Law CW, Taylor VH, Woldeyohannes HO, Alsuwaidan MT, Soczynska JK, Kim B, Lourenco MT, Kahn LS, Goldstein BI: Metabolic syndrome and major depressive disorder: co-occurrence and pathophysiologic overlap. Curr Diab Rep. 2009, 9: 51-59.CrossRefPubMed
14.
Viinamaki H, Heiskanen T, Lehto SM, Niskanen L, Koivumaa-Honkanen H, Tolmunen T, Honkalampi K, Saharinen T, Haatainen K, Hintikka J: Association of depressive symptoms and metabolic syndrome in men. Acta Psychiatr Scand. 2009, 120: 23-29.CrossRefPubMed
15.
Takeuchi T, Nakao M, Kachi Y, Yano E: Association of metabolic syndrome with atypical features of depression in Japanese people. Psychiatry Clin Neurosci. 2013, 67: 532-539.CrossRefPubMed
16.
Kahl KG, Greggersen W, Schweiger U, Cordes J, Balijepalli C, Lösch C, Moebus S: Prevalence of the metabolic syndrome in unipolar major depression. Eur Arch Psychiatry Clin Neurosci. 2012, 262: 313-320.CrossRefPubMed
17.
Goldbacher EM, Bromberger J, Matthews KA: Lifetime history of major depression predicts the development of the metabolic syndrome in middle-aged women. Psychosom Med. 2009, 71: 266-272.CrossRefPubMedPubMedCentral
18.
McIntyre RS, Filteau MJ, Martin L, Patry S, Carvalho A, Cha DS, Barakat M, Miguelez M: Treatment-resistant depression: Definitions, review of the evidence, and algorithmic approach. J Affect Disord. 2014, 156: 1-7.CrossRefPubMed
19.
Herva A, Rasanen P, Miettunen J, Timonen M, Läksy K, Veijola J, Laitinen J, Ruokonen A, Joukamaa M: Co-occurrence of metabolic syndrome with depression and anxiety in young adults: the Northern Finland 1966 Birth Cohort Study. Psychosom Med. 2006, 68: 213-216.CrossRefPubMed
20.
Hildrum B, Mykletun A, Midthjell K, Ismail K, Dahl AA: No association of depression and anxiety with the metabolic syndrome: the Norwegian HUNT study. Acta Psychiatr Scand. 2009, 120: 14-22.CrossRefPubMed
21.
Butnoriene J, Bunevicius A, Norkus A, Bunevicius R: Depression but not anxiety is associated with metabolic syndrome in primary care based community sample. Psychoneuroendocrinology. 2014, 40: 269-276.CrossRefPubMed
22.
Carroll D, Phillips AC, Thomas GN, Gale CR, Deary I, Batty GD: Generalized anxiety disorder is associated with metabolic syndrome in the Vietnam experience study. Biol Psychiatry. 2009, 66: 91-93.CrossRefPubMed
23.
Albert U, Aguglia A, Chiarle A, Bogetto F, Maina G: Metabolic syndrome and obsessive-compulsive disorder: a naturalistic Italian study. Gen Hosp Psychiatry. 2013, 35: 154-159.CrossRefPubMed
24.
First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). 2002, New York: Biometrics Research, New York State Psychiatric Institute
25.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, Text Revision. 2000, Washington, DC: American Psychiatric AssociationCrossRef
26.
Hamilton M: Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967, 6: 278-296.CrossRefPubMed
27.
Hung CI, Liu CY, Wang SJ, Yao YC, Yang CH: The cut-off points of the Depression and Somatic Symptoms Scale and the Hospital Anxiety and Depression Scale in detecting non-full remission and a current major depressive episode. Int J Psychiatry Clin Pract. 2012, 16: 33-40.CrossRefPubMed
28.
Hung CI, Liu CY, Wang SJ, Juang YY, Yang CH: Somatic symptoms: an important index in predicting the outcome of depression at six-month and two-year follow-up points among outpatients with major depressive disorder. J Affect Disord. 2010, 125: 134-140.CrossRefPubMed
29.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983, 67: 361-370.CrossRefPubMed
30.
Duncan EJ, Woolson SL, Hamer RM, Dunlop BW: Risk of lipid abnormality with haloperidol, olanzapine, quetiapine, and risperidone in a Veterans Affairs population. Int Clin Psychopharmacol. 2009, 24: 204-213.CrossRefPubMed
31.
Stahl SM, Mignon L, Meyer JM: Which comes first: atypical antipsychotic treatment or cardiometabolic risk?. Acta Psychiatr Scand. 2009, 119: 171-179.CrossRefPubMed
32.
Torrent C, Amann B, Sanchez-Moreno J, Colom F, Reinares M, Comes M, Rosa AR, Scott J, Vieta E: Weight gain in bipolar disorder: pharmacological treatment as a contributing factor. Acta Psychiatr Scand. 2008, 118: 4-18.CrossRefPubMed
33.
Hwang LC, Bai CH, Chen CJ: Prevalence of obesity and metabolic syndrome in Taiwan. J Formos Med Assoc. 2006, 105: 626-635.CrossRefPubMed
34.
Barnes RD, Boeka AG, McKenzie KC, Genao I, Garcia RL, Ellman MS, Ellis PJ, Masheb RM, Grilo CM: Metabolic syndrome in obese patients with binge-eating disorder in primary care clinics: a cross-sectional study. Prim Care Companion CNS Disord. 2011, 13 (2):
35.
Blomquist KK, Milsom VA, Barnes RD, Boeka AG, White MA, Masheb RM, Grilo CM: Metabolic syndrome in obese men and women with binge eating disorder: developmental trajectories of eating and weight-related behaviors. Compr Psychiatry. 2012, 53: 1021-1027.CrossRefPubMedPubMedCentral
36.
Richter N, Juckel G, Assion H-J: Metabolic syndrome: a follow-up study of acute depressive inpatients. Eur Arch Psychiatry Clin Neurosci. 2010, 260: 41-49.CrossRefPubMed
37.
Garcia-Portilla MP, Saiz PA, Benabarre A, Sierra P, Perez J, Rodriguez A, Livianos L, Torres P, Bobes J: The prevalence of metabolic syndrome in patients with bipolar disorder. J Affect Disord. 2008, 106: 197-201.CrossRefPubMed
38.
Wu RR, Zhao JP, Liu ZN, Zhai JG, Guo XF, Guo WB, Tang JS: Effects of typical and atypical antipsychotics on glucose-insulin homeostasis and lipid metabolism in first-episode schizophrenia. Psychopharmacology. 2006, 186: 572-578.CrossRefPubMed
Metadata
Title
Metabolic syndrome among psychiatric outpatients with mood and anxiety disorders
Publication date
01-12-2014
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-14-185

Other articles of this Issue 1/2014

BMC Psychiatry 1/2014 Go to the issue

Research article

Day occupation is associated with psychopathology for adolescents and young adults with Down syndrome

Research article

Health beliefs and carer burden in first episode psychosis

Research article

Clinical predictors associated with full remission versus episode of major depressive disorder outpatients: the experience at a teaching hospital in Taiwan

Research article

Collaborative development of an electronic Personal Health Record for people with severe and enduring mental health problems

Research article

Cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: a systematic review and meta-analysis

Research article

Deployment-related mild traumatic brain injury, mental health problems, and post-concussive symptoms in Canadian armed forces personnel