Abstract

Background: Metabolic syndrome (MetS) has been found to be highly prevalent worldwide ranging from 11.2% to 47%. It is suggested that bipolar affective disorder (BPAD) and MetS share common risk factors including the treatment of the latter one, especially second-generation antipsychotics. The study tries to find out a significant correlation among various parameters, if any. Objectives: (i) To determine physical parameters such as blood pressure (BP) and waist circumference in drug-naïve and drug-free patients vis-a-vis in control subject across various sociodemographic parameters; (2) to find out the prevalence of MetS in drug-naïve/drug-free patients of bipolar disorder and control subjects and to compare with that of control subjects.
Materials and Methods: The study was a comparative, cross-sectional, case-control, hospital-based study using purposive sampling method. Patients were taken up for the study from October 2013 to June 2015. The study included cases (79 = drug-naïve 36 + drug-free 43; aged 16-55 years) and control (50). For control, people with General Health Questionnaire 12 score <15 were selected. All patients were diagnosed as BPAD as per the criteria laid by the WHO (ICD-10 DCR), and only those were selected who had never received medications in their lifetime or were drug-free for at least 1 year. API criteria for the diagnosis of MetS for Asian Indians were used. Subjects crossing cutoff values in 3 or more parameters were considered to have MetS. Those crossing cutoff values in 2 or 1 parameter were considered sub-MetS (SMet2 and SMet1, respectively).
Results: Percentage of married individuals was high in control group. Control group had exclusively Hindu population. Moreover, there were more urban people in control group. Otherwise, there was no significant difference in sociodemographic profiles of bipolar patients and control group. Patients had systolic BP (SBP) 120.27 ± 5.74 and control had 116.32 ± 5.67, both in the normal range, but the difference was significant statistically. Age and gender had a significant positive correlation with waist circumference but not with BP. Marital status had a significant correlation with waist circumference, but age can be considered here as a confounding factor. Age of individual had a positive correlation with waist circumference. Sex of individual in control group had a significant correlation with waist circumference. Education level had a negative correlation with waist circumference. Conclusion: Some factors (such as age, education, gender, marital status, and SBP) affect the factors already known to be correlated to MetS. Causal web analysis could give an exact level of their contribution and/or progression of the MetS in the cases of bipolar affective disorder, irrespective of drug status.