Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center

BAHÇECİ, Bülent; KARATAŞ, Kader Semra; Aktürk, Hediye; ALAKUŞ, Feride

doi:10.14744/scie.2019.05924

Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center

Kader Semra KARATAŞ, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, Rize, Türkiye)

Bülent BAHÇECİ, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, Rize, Türkiye)

Hediye AKTÜRK, (Rize Devlet Hastanesi, Psikiyatri Kliniği, Rize, Türkiye)

Feride ALAKUŞ (Rize Devlet Hastanesi, İç Hastalıkları Kliniği, Rize, Türkiye)

Southern Clinics of Istanbul Eurasia

2 2

Yıl: 2019 Cilt: 30 Sayı: 3 Sayfa Aralığı: 266 - 271 Metin Dili: İngilizce DOI: 10.14744/scie.2019.05924 İndeks Tarihi: 24-06-2020

Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center

Öz:

Objective: The aim of this study was to determine the frequency of metabolic syndrome(MetS) in patients with schizophrenia and bipolar disorder (BD) receiving antipsychotic (AP)medications.Methods: A total of 207 patients with schizophrenia and BD, diagnosed according to theDSM-IV criteria and receiving a regular AP treatment, were followed up in the CommunityMental Health Center. The MetS was diagnosed according to the diagnostic criteria of theInternational Diabetes Federation. Patients with MetS were compared to those withoutit in terms of sociodemographic and clinical characteristics, as well as the AP medicationsadministered.Results: MetS was detected in 28.5% of patients. The most commonly identified clinicalfinding was a large waist circumference (61%). Of the clinical characteristics among the patients using AP, a large waist circumference and high blood glucose levels were found to besignificantly different. MetS was found to be more common in patients with schizophreniaon AP who used the clozapine monotherapy (18.6%), and in patients with BD who usedquetiapine (11.9%). Valproate was found to be more commonly used in patients with BD inwhom MetS was detected.Conclusion: A large waist circumference and high blood glucose levels are the most important follow-up criteria.

Anahtar Kelime:

Toplum Ruh Sağlığı Merkezinde Takip Edilen Şizofreni ve İki Uçlu Bozukluk Hastalarında Metabolik Sendrom

Öz:

Amaç: Bu çalışmada, antipsikotik ilaçlarla tedavi altında olan şizofreni ve iki uçlu bozukluk (İUB) hastalarında metabolik sendrom (MetS) sıklığının saptanması amaçlanmıştır. Gereç ve Yöntem: DSM-IV tanı kriterlerine göre tanısı konan, Toplum Ruh Sağlığı Merkezi’nde takip edilen, düzenli antipsikotik tedavi alan 207 şizofreni ve İUB hastaları çalışmaya alındı. MetS tanısı Uluslararası Diyabet Fedarasyonu tanı kriterlerine göre kondu. MetS tanısı konan hasta grupları arasında sosyodemografik, klinik özellikler ve uygulanan antipsikotik ilaçlar açısından karşılaştırma yapıldı. Bulgular: Hastaların %28.5’inde MetS saptandı. En sık saptanan klinik bulgu, bel çevresi genişliği (%61) idi. Antipsikotik kullanan hastalarda klinik özellikler arasında bel çevresi genişliği ve kan glukoz seviyesi yüksekliği anlamlı olarak farklı bulundu. Antipsikotik kullanan şizofreni hastalarında monoterapilerde klozapin (%18.6), İUB hastalarında ketiyapin (%11.9) kullanımında MetS daha sık olarak bulundu. MetS saptanan İUB hastalarında duygudurum düzenleyici ilaç olarak valproatın daha sık kullanıldığı saptandı. Sonuç: Bel çevresi genişliği ve kan şekeri yüksekliği takipte en önemli kriterlerdir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. DE Hert M, Correll CU, Bobes J, Cetkovich-Bakmas M, Cohen D, Asai I,et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 2011;10:52–77.
2. 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. Schizophr Bull 2013;39:306–18.
3. Sarısoy G, Boke O, Ozturk A, Akkaya D, Pazvantoglu O, Sahin AR. The Correlation Between Incidence of Metabolic Syndrome and Sociodemographic and Clinical Characteristics in Schizophrenia Patients. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2013;26:267–275.
4. Aksu H. Bipolar bozukluk tanisi ile takip edilen hastalarda gorulebilen metabolik sendroma iliskin, ruh sagligi calisanlarinin farkindaligi ve diger etkenlerle iliskisi. Postgraduate thesis. Bakırkoy Research and Training Hospital for Mental and Nervous Diseases, Istanbul. 2009.
5. Yumru M, Savas HA, Kurt E, Kaya MC, Selek S, Savas E, et al. Atypical antipsychotics related metabolic syndrome in bipolar patients. J Affect Disord 2007;98:247–52.
6. Guveli H, Ilnem MC, Yener F, Karamustafalioglu N, Ipekcioglu D, Abanoz Z. Antipsikotik Kullanan Şizofreni Hastalarında Metabolik Sendrom Sıklığı ve İlişkili Etmenleri. Yeni Symposium 2011;49:67–76.
7. Cerit C, Vural M, Bos Gelmez SÜ, Ozten E, Aker AT, Yıldız M. Metabolic syndrome with different antipsychotics: a multicentre cross-sectional study. Psychopharmacol Bull 2010;43:22–36.
8. Yazici MK, Anil Yağcioğlu AE, Ertuğrul A, Eni N, Karahan S, Karaağaoğlu E, et al. The prevalence and clinical correlates of metabolic syndrome in patients with schizophrenia: findings from a cohort in Turkey. Eur Arch Psychiatry Clin Neurosci 2011;261:69–78.
9. Grover S, Aggarwal M, Dutt A, Chakrabarti S, Avasthi A, Kulhara P, et al. Prevalence of metabolic syndrome in patients with schizophrenia in India. Psychiatry Res 2012;200:1035–7.
10. Kang SH, Kim KH, Kang GY, Lee KH, Kim KK, Soh M, et al. Cross-sectional prevalence of metabolic syndrome in Korean patients with schizophrenia. Schizophr Res 2011;128:179–81.
11. Kagal UA, Torgal SS, Patil NM, Malleshappa A. Prevalence of the metabolic syndrome in schizophrenic patients receiving second-generation antipsychotic agents--a cross-sectional study. J Pharm Pract 2012;25:368–73.
12. Correll CU, Frederickson AM, Kane JM, Manu P. Does antipsychotic polypharmacy increase the risk for metabolic syndrome? Schizophr Res 2007;89:91–100.
13. Fagiolini A, Frank E, Scott JA, Turkin S, Kupfer DJ. Metabolic syndrome in bipolar disorder: findings from the Bipolar Disorder Center for Pennsylvanians. Bipolar Disord 2005;7:424–30.
14. Bly MJ, Taylor SF, Dalack G, Pop-Busui R, Burghardt KJ, Evans SJ, et al. Metabolic syndrome in bipolar disorder and schizophrenia: dietary and lifestyle factors compared to the general population. Bipolar Disord 2014;16:277–88.
15. Boke O, Aker S, Sarisoy G, Saricicek EB, Sahin AR. Prevalence of metabolic syndrome among inpatients with schizophrenia. Int J Psychiatry Med 2008;38:103–12.
16. Sanisoglu SY, Oktenli C, Hasimi A, Yokusoglu M, Ugurlu M. Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health 2006;6:92.
17. Vancampfort D, Knapen J, Probst M, van Winkel R, Deckx S, Maurissen K, et al. Considering a frame of reference for physical activity research related to the cardiometabolic risk profile in schizophrenia. Psychiatry Res 2010;177:271–9.
18. Kaya MC, Vırıt O, Altındag A, Selek S, Bulbul F, Bulut M, et al. Şizofrenide Metabolik Sendrom Sıklığı, Metabolik Sendromun Özellikleri ve Kullanılan Antipsikotiklerle İlişkisi. Noropsikiyatri Arsivi 2009;46:13–18.
19. Fagiolini A, Chengappa KN, Soreca I, Chang J. Bipolar disorder and the metabolic syndrome: causal factors, psychiatric outcomes and economic burden. CNS Drugs 2008;22:655–69.
20. Malhotra N, Kulhara P, Chakrabarti S, Grover S. Lifestyle related factors & impact of metabolic syndrome on quality of life, level of functioning & self-esteem in patients with bipolar disorder & schizophrenia. Indian J Med Res 2016;143:434–42.
21. Yood MU, DeLorenze G, Quesenberry CP Jr, Oliveria SA, Tsai AL, Willey VJ, et al. The incidence of diabetes in atypical antipsychotic users differs according to agent-results from a multisite epidemiologic study. Pharmacoepidemiol Drug Saf 2009;18:791–9.
22. Kessing LV, Thomsen AF, Mogensen UB, Andersen PK. Treatment with antipsychotics and the risk of diabetes in clinical practice. Br J Psychiatry 2010;197:266–71.
23. Koller E, Schneider B, Bennett K, Dubitsky G. Clozapine-associated diabetes. Am J Med 2001;111:716–23.
24. McElroy SL, Guerdjikova A, Kotwal R. Severe mental illness and obesity. In: Bermudes RA, Keck PE, McElroy SL, editors. Managing metabolic abnormalities in the psychiatrically ill: a clinical guide for psychiatrists. Arlington: American Psychiatric Publishing; 2006. p. 55–119.
25. Torrent C, Amann B, Sánchez-Moreno J, Colom F, Reinares M, Comes M, et al. Weight gain in bipolar disorder: pharmacological treatment as a contributing factor. Acta Psychiatr Scand 2008;118:4–18.
26. Stein K. When essential medications provoke new health problems: the metabolic effects of second-generation antipsychotics. J Am Diet Assoc 2010;110:992–1001.
27. Weiden PJ, Newcomer JW, Loebel AD, Yang R, Lebovitz HE. Longterm changes in weight and plasma lipids during maintenance treatment with ziprasidone. Neuropsychopharmacology 2008;33:985– 94.
28. Demirel A, Demire ÖF, Uğur M. Atipik Antipsikotiklere Bağlı Metabolik Sendrom Psikiyatride Güncel Yaklaşımlar 2015;7:81– 97.
29. Kasteng F, Eriksson J, Sennfält K, Lindgren P. Metabolic effects and cost-effectiveness of aripiprazole versus olanzapine in schizophrenia and bipolar disorder. Acta Psychiatr Scand 2011;124:214–25.
30. Wani RA, Dar MA, Chandel RK, Rather YH, Haq I, Hussain A, et al. Effects of switching from olanzapine to aripiprazole on the metabolic profiles of patients with schizophrenia and metabolic syndrome: a double-blind, randomized, open-label study. Neuropsychiatr Dis Treat 2015;11:685–93.
31. Genc A, Kalelioglu T, Tasdemir A, Genc ES, Ozver I, Yesilbas D, et al. The Prevalance of Metabolic Syndrome Parameters Among Bipolar Disorder Outpatients on Lithium Monotherapy. Bulletin of Clinical Psychopharmacology 2012;22:320–324.
32. Bowden CL, Calabrese JR, McElroy SL, 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;57:481–9.

APA	KARATAŞ K, BAHÇECİ B, Aktürk H, ALAKUŞ F (2019). Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. , 266 - 271. 10.14744/scie.2019.05924
Chicago	KARATAŞ Kader Semra,BAHÇECİ Bülent,Aktürk Hediye,ALAKUŞ Feride Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. (2019): 266 - 271. 10.14744/scie.2019.05924
MLA	KARATAŞ Kader Semra,BAHÇECİ Bülent,Aktürk Hediye,ALAKUŞ Feride Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. , 2019, ss.266 - 271. 10.14744/scie.2019.05924
AMA	KARATAŞ K,BAHÇECİ B,Aktürk H,ALAKUŞ F Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. . 2019; 266 - 271. 10.14744/scie.2019.05924
Vancouver	KARATAŞ K,BAHÇECİ B,Aktürk H,ALAKUŞ F Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. . 2019; 266 - 271. 10.14744/scie.2019.05924
IEEE	KARATAŞ K,BAHÇECİ B,Aktürk H,ALAKUŞ F "Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center." , ss.266 - 271, 2019. 10.14744/scie.2019.05924
ISNAD	KARATAŞ, Kader Semra vd. "Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center". (2019), 266-271. https://doi.org/10.14744/scie.2019.05924

APA	KARATAŞ K, BAHÇECİ B, Aktürk H, ALAKUŞ F (2019). Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. Southern Clinics of Istanbul Eurasia, 30(3), 266 - 271. 10.14744/scie.2019.05924
Chicago	KARATAŞ Kader Semra,BAHÇECİ Bülent,Aktürk Hediye,ALAKUŞ Feride Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. Southern Clinics of Istanbul Eurasia 30, no.3 (2019): 266 - 271. 10.14744/scie.2019.05924
MLA	KARATAŞ Kader Semra,BAHÇECİ Bülent,Aktürk Hediye,ALAKUŞ Feride Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. Southern Clinics of Istanbul Eurasia, vol.30, no.3, 2019, ss.266 - 271. 10.14744/scie.2019.05924
AMA	KARATAŞ K,BAHÇECİ B,Aktürk H,ALAKUŞ F Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. Southern Clinics of Istanbul Eurasia. 2019; 30(3): 266 - 271. 10.14744/scie.2019.05924
Vancouver	KARATAŞ K,BAHÇECİ B,Aktürk H,ALAKUŞ F Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center. Southern Clinics of Istanbul Eurasia. 2019; 30(3): 266 - 271. 10.14744/scie.2019.05924
IEEE	KARATAŞ K,BAHÇECİ B,Aktürk H,ALAKUŞ F "Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center." Southern Clinics of Istanbul Eurasia, 30, ss.266 - 271, 2019. 10.14744/scie.2019.05924
ISNAD	KARATAŞ, Kader Semra vd. "Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder in a Community Mental Health Center". Southern Clinics of Istanbul Eurasia 30/3 (2019), 266-271. https://doi.org/10.14744/scie.2019.05924