Title: Bipolar Disorder, Schizophrenia, and Metabolic Syndrome
Abstract: Back to table of contents Previous article Next article Communications and UpdatesFull AccessBipolar Disorder, Schizophrenia, and Metabolic SyndromeFrancesco Bartoli, M.D., Ph.D., Giuseppe Carrà, M.D., M.Sc., Ph.D., Cristina Crocamo, M.Sc., Daniele Carretta, M.D., and Massimo Clerici, M.D., Ph.D.Francesco BartoliSearch for more papers by this author, M.D., Ph.D., Giuseppe CarràSearch for more papers by this author, M.D., M.Sc., Ph.D., Cristina CrocamoSearch for more papers by this author, M.Sc., Daniele CarrettaSearch for more papers by this author, M.D., and Massimo ClericiSearch for more papers by this author, M.D., Ph.D.Published Online:1 Aug 2013https://doi.org/10.1176/appi.ajp.2013.13040447AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: In the March issue, Vancampfort et al. (1) reported valuable data by conducting a meta-analysis of published studies on rates of metabolic syndrome among people with bipolar disorder. In the general findings paragraph, they also compared prevalence of metabolic syndrome among different psychiatric disorders. Rates appeared to be significantly higher in bipolar patients, 37.3% (95% confidence interval [CI]=36.1–39.0), than in schizophrenia patients, 32.5% (95% CI=30.1–35.0) (2). The authors advised caution in interpreting this finding because of the lack of data allowing direct comparison between individuals with schizophrenia and bipolar disorder. However, we believe that this is an important issue that should be more thoroughly assessed and commented on. Among articles screened for suitability for inclusion in meta-analysis, 11 provided data on metabolic syndrome prevalence rates of 3,888 unique participants: 1,572 with bipolar disorder and 2,316 with schizophrenia. Therefore, there may well be sufficient data for a supplementary analysis assessing differences on metabolic syndrome rates between these diagnostic subgroups.A pooled analysis based on a random-effects model and using odds ratio as an association measure is depicted in Figure 1. The number of individuals with metabolic syndrome was 705 among bipolar patients and 890 among schizophrenia patients. The pooled odds ratio (bipolar compared with schizophrenia) was 1.01 (95% CI=0.82–1.24; p=0.93), with low heterogeneity across the studies (I2=31%; p=0.15). In addition, a subanalysis based on four studies reporting significantly higher rates of antipsychotic prescriptions in people with schizophrenia revealed a similar chance of metabolic syndrome for individuals with bipolar disorder (odds ratio=0.98, 95% CI=0.70–1.38; p=0.91). Further subanalyses did not reveal any statistical difference. We believe these findings may well complement those reported by Vancampfort et al. (1). Individuals with bipolar disorder and schizophrenia have comparable chances of having metabolic syndrome. Despite important differences in clinical features, these individuals may actually share a number of health behaviors, including poor physical activity, unhealthy diet, excessive alcohol intake, and smoking habits. Future research should assess the relative contribution to metabolic syndrome not only of different psychiatric diagnoses, but also of components such as genetics, antipsychotic medication use, lifestyle, and health behaviors.FIGURE 1. Association Estimate for Metabolic Syndrome in Bipolar Disorder Compared With Schizophrenia and Other Psychotic DisordersFrom the Department of Surgery and Interdisciplinary Medicine, University of Milan Bicocca, Milan, Italy; the Mental Health Sciences Unit, Faculty of Brain Sciences, University College London; and the Department of Mental Health, San Gerardo Hospital, Monza, Italy.The authors report no financial relationships with commercial interests.References1 Vancampfort D, Vansteelandt K, Correll CU, Mitchell AJ, De Herdt A, Sienaert P, Probst M, De Hert M: Metabolic syndrome and metabolic abnormalities in bipolar disorder: a meta-analysis of prevalence rates and moderators. Am J Psychiatry 2013; 170:265–274Link, Google Scholar2 Mitchell AJ, Vancampfort D, Sweers K, van Winkel R, Yu W, De Hert M: Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders: a systematic review and meta-analysis. 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Neill epperson, M.D., Michael E. Thase, M.D., and Deborah r. Kim, M.D.1 August 2013 | American Journal of Psychiatry, Vol. 170, No. 8Response to Bartoli et al.Davy Vancampfort, Ph.D., Alex J. Mitchell, M.D., Christoph U. Correll, M.D., Pascal Sienaert, M.D., Ph.D., and Marc De Hert, M.D., Ph.D.1 August 2013 | American Journal of Psychiatry, Vol. 170, No. 8 Volume 170Issue 8 August 2013Pages 927-928 Metrics PDF download History Accepted 1 June 2013 Published online 1 August 2013 Published in print 1 August 2013
Publication Year: 2013
Publication Date: 2013-08-01
Language: en
Type: letter
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 32
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