Objective: We aim to determine the prevalence of obesity and overweight in bipolar I patients, and to examine their associations with the demographic, clinical and therapeutic characteristics of this population. Patients and Methods : Our study included 120 bipolar I patients (79 men and 41 women, mean age = 39.5 ± 11.9 years). Weight and height were evaluated by body mass index (BMI). Obesity was defined when BMI ≥ 30 kg /m2 and overweight when BMI ≥ 25 kg /m2. Results : The prevalence of obesity and overweight w as respectively 32.5% and 30.8%. Obesity was signifi cantly more frequent in women than men. The illness duration was significantly longer in obese patients than in those with normal weight. Moreover, the family history of medical disorders and concomitant medical disorders w as signifi cantly more frequent in obese patients than in those with normal weight. However, any significant association between therapeutic characteristics and obesity or overweight was found. Conclusions: Obesity and overweight were frequent in bipolar I patients. Obesity was significantly frequent in women and significantly associated with illness duration, medi cal disorders, and concomitant medical disorders. These results emphasize d the need for specific treatment strategies and programs for weight control for these patients.
KeywordsBipolar I DisorderObesityOverweight
F. Marmol, “Lithium: Bipolar Disorder and Neurodegenerative Diseases Possible Cellular Mechanisms of the Therapeutic Effects of Lithium,” Progress in Neuro-Psychopharmacology & Biological Psychiatry, Vol. 32, No. 8, 2008, pp. 1761-1771. doi:10.1016/j.pnpbp.2008.08.012
G. E. Simon, “Social and Economic Burden of Mood Disorders,” Biological Psychiatry, Vol. 54, No. 3, 2003, pp. 208-215. doi:10.1016/S0006-3223(03)00420-7
H. U. Wittchen, S. Muhlig and L. Pezawas, “Natural Course and Burden of Bipolar Disorders,” The International Journal of Neuropsychopharmacology, Vol. 6, No. 2, 2003, pp. 145-154. doi:10.1017/S146114570300333X
S. W. Woods, “The Economic Burden of Bipolar Disease,” Journal of Clinical Psychiatry, Vol. 61, 2000, pp. 38-41.
A. Ezzaher, D. Haj Mouhamed, A. Mechri, F. Neffati, W. Douki, L. Gaha and M. F. Najjar, “Association between Bipolar I Disorder and the L55M and Q192R Polymorphisms of the Paraoxonase 1 (PON1) Gene,” Journal of Affective Disorders, Vol. 139, No. 1, 2012, pp. 12-17. doi:10.1016/j.jad.2011.06.029
D. A. Revicki, L. S. Matza, E. Flood and A. Lloyd, “Bipolar Disorder and Health-Related Quality of Life: Review of Burden of Disease and Clinical Trials,” Pharmacoeconomics, Vol. 23, 2005, pp. 583-594. doi:10.2165/00019053-200523060-00005
R. J. Wyatt and I. Henter, “An Economic Evaluation of Manicdepressive Illness: 1991,” Social Psychiatry and Psychiatric Epidemiology, Vol. 30, No. 5, 1995, pp. 213-219.
M. De Hert, C. U. Correll, J. Bobes, M. Cetkovich-Bakmas, D. Cohen, I. Asai J. Detraux, S. Gautam, H. J. Moller, D. M. Ndetei, J. W. Newcomer, R. Uwakwe and S. Leucht, “Physical Illness in Patients with Severe Mental Disorders. I. Prevalence, Impact of Medications and Disparities in Health Care,” World Psychiatry, Vol. 10, 2011, pp. 52-77.
D. E. Casey, “Metabolic Issues and Cardiovascular Disease in Patients with Psychiatric Disorders,” American Journal of Medicine, Vol. 118, 2005, pp. 15-22.
S. Malhotra and S. L. McElroy, “Medical Management of Obesity Associated with Mental Disorders,” Journal of Clinical Psychiatry, Vol. 63, 2002, pp. 24-32.
American Psychiatric Association, “Diagnostic and Statistical Manual of Mental Disorders,” 4 Edition, American Psychiatric Association, Washington DC, 2004.
World Health Organization, “Obesity: Preventing and Managing the Global Epidemic (publication WHO/NUT/ NCD/98.1),” WHO, Geneva, 1997.
H. Pijil and A. E. Meinders, “Bodyweight Change as an Adverse Effect of Drug Treatment: Mechanisms and Management,” Drug Safety, Vol. 14, 1996, pp. 329-342. doi:10.2165/00002018-199614050-00005
J. L. Elmslie, J. T. Silverstone, J. L. Mann, S. M. Williams and S. E. Romans, “Prevalence of Overweight and Obesity in Bipolar Patients,” Journal of Clinical Psychiatry, Vol. 61, 2000, pp. 179-184. doi:10.4088/JCP.v61n0306
A. Fagiolini, E. Frank, P. R. Houck, A. G. Mallinger, H. A. Swartz, D. J. Buysse, H. Ombao and D. J. Kupfer, “Prevalence of Obesity and Weight Change during Treatment in Patients with Bipolar I Disorder,” Journal of Clinical Psychiatry, Vol. 63, 2002, pp. 528-533. doi:10.4088/JCP.v63n0611
S. L. McElroy, R. Kotwal, S. Malhotra, E. B. Nelson, P. E. Keck and C. B. Nemeroff, “Are Mood Disorders and Obesity Related? A Review for the Mental Health Professional,” Journal of Clinical Psychiatry, Vol. 65, 2004, pp. 634-651. doi:10.4088/JCP.v65n0507
F. G. Haddad, H. Brax, E. Zein and T. Abou el Hessen, “L’obésité et les Pathologies Associées dans un Centre de Soins au Liban,” Journal Medical Libanais, Vol. 54, 2006, pp. 152-155.
A. Fagiolini, D. J. Kupfer, P. R. Houck, D. M. Novick and E. Frank, “Obesity as a Correlate of Outcome in Patients with Bipolar I Disorder,” American Journal of Medicine, Vol. 160, 2003, pp. 112-117.
M. P. Garcia-Portilla, P. A. Saiz, M. T. Bascaran, S. Martinez, A. Benabarre, P. Sierra, P. Torres, J. M. Montes, M. Bousono and J. Bobes, “Cardiovascular Risk in Patients with Bipolar Disorder,” Journal of Affective Disorders, Vol. 115, No. 3, 2009, pp. 1-7. doi:10.1016/j.jad.2008.09.008
A. Ezzaher, D. Haj Mouhamed, A. Mechri, F. Neffati, W. Douki, L. Gaha and M. F. Najjar, “Cardiovascular Risk in Tunisian Patients with Bipolar I Disorder,” DyslipidemiaFrom Prevention to Treatment, Rijeka, 2012.
J. Pinkney, “Implications of Obesity for Diabetes and Coronary Heart Disease in Clinical Practice,” Britsh Journal of Diabetes and Vascular Disease, Vol. 1, No. 2, 2001, pp. 103-106. doi:10.1177/14746514010010020701
P. W. Wang, G. S. Sachs, C. A. Zarate, L. B. Marangell, J. R. Calabrese, J. F. Goldberg, K. Sagduyu, S. Miyahara and T. A. Ketter, “Overweight and Obesity in Bipolar Disorders,” Journal of Psychiatric Research, Vol. 40, No. 8, 2006, pp. 762-764. doi:10.1016/j.jpsychires.2006.01.007
R. S. McIntyre, J. Z. Konarski, K. Wilkins, J. K. Soczynska and S. H. Kennedy, “Obesity in Bipolar Disorder and Major Depressive Disorder: Results from a National Community Health Survey on Mental Health and Well-Being,” Canadian Journal of Psychiatry, Vol. 51, No. 5, 2006, pp. 274-280.
P. J. R. Teixeira and F. L. Rocha, “The Prevalence of Metabolic Syndrome among Psychiatric Inpatients in Brazil,” Brazilian Journal of Psychiatry, Vol. 29, No. 4, 2007, pp. 330-336.
A. Ezzaher, D. Haj Mouhamed, A. Mechri, F. Neffati, W. Douki, L. Gaha and M. F. Najjar, “Lower Paraoxonase 1 Activity in Tunisian Bipolar I Patients,” Annals of General Psychiatry, Vol. 9, 2010, p. 36. doi:10.1186/1744-859X-9-36
G. Maina, V. Salvi , A. Vitalucci, V. D’Ambrosio and F. Bogetto, “Prevalence and Correlates of Overweight in Drug-Naive Patients with Bipolar Disorder,” Journal of Affective Disorders, Vol. 110, No. 1-2, 2008, pp. 149-155. doi:10.1016/j.jad.2007.12.233
A. J. Stunkard, M. S. Faith and K. C. Allison, “Depression and Obesity,” Biological Psychiatry, Vol. 54, No. 3, 2003, pp. 330-337. doi:10.1016/S0006-3223(03)00608-5
G. Cheymol, “Effects of Obesity on Pharmacokinetics Implications for Drug Therapy,” Clinical Pharmacokinetics, Vol. 39, No. 3, 2000, pp. 215-231. doi:10.2165/00003088-200039030-00004
D. T. Plante and J. W. Winkelman, “Sleep Disturbance in Bipolar Disorder: Therapeutic Implications,” American Journal of Psychiatry, Vol. 165, No. 7, 2008, pp. 830-843. doi:10.1176/appi.ajp.2008.08010077
A. Ezzaher, D. Haj Mouhamed, A. Mechri, F. Neffati, W. Douki, L. Gaha and M. F. Najjar, “Obesity and Dyslipidemia in Tunisian Bipolar Subjects,” Annales de Biologie Clinique, Vol. 68, 2010, pp. 277-284.
D. C. Lagace, R. S. Mcleod and M. W. Nachtigal, “Valproic Acid Inhibits Leptin Secretion and Reducesleptin Messenger Ribonucleic Acid Levels in Adipocytes,” Endocrinology, Vol. 145, No. 12, 2004, p. 5493. doi:10.1210/en.2004-0877