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S062-2

Metabolic Syndrome in Patients with Schizophrenia and Bipolar Disorder

Ya-Mei Bai

Taipei Veterans General Hospital, National Yang-Ming University, Taiwan

Background/Objective: Second-generation antipsychotics are widely used for patients with
schizophrenia and bipolar disorder, but the associated increasing risk of metabolic syndrome and
cardiovascular disorder are concerned. Among the patients with schizophrenia, the association of
weight gain and better clinical outcome was noted in clozapine from our previous 8-year cohort
study (1), as well as risperidone and olanzapine in other studies (2). But the association between
clinical outcome and metabolic syndrome were rarely investigated among patients with bipolar
disorder.

Method: The prevalence of metabolic syndrome (2005 International Diabetes Federation Asia
criteria), adipokins, and clinical outcome were compared among 567 patients with schizophrenia and
160 patients with bipolar disorder.

Result: The prevalence of metabolic syndrome was comparable among patients with schizophrenia
(28.7%) and bipolar disorder (29.4%). Both the levels of adiponectin and insulin were independent
predictors for metabolic syndrome among patients with schizophrenia and bipolar disorder after
adjusting age, gender and BMI. Contrary to previous reports that weight gain was associated with
better clinical outcome among patients with schizophrenia, the bipolar patients with metabolic
syndrome were with poorer clinical outcomes: with more previous hospitalizations, more clinical
side effects such as extrapyramidal side effect, akathesia and involuntary movement side effect, and
poorer global functioning, poorer insight, and poorer executive function on the Wisconsin Card
Sorting Test.

Conclusion: High prevalence of metabolic syndrome is noted in both patients with schizophrenia
and bipolar disorder, and with increased cardiovascular risk. But the influence of psychiatric clinical
outcome may be different. The balance between efficacy and side effects of pharmacotherapy among
the patients with major mental disorders were important.

Reference: Bai YM, Lin CC, Chen JY, et al. Association of initial antipsychotic response to
clozapine and long-term weight gain. Am J Psychiatry 2006;163: 1276-1279
Basson BR, Kinon BJ, Taylor CC, Szymanski KA, Gilmore JA, Tollefson GD. J Clin Psychiatry.
2001 Apr;62(4):231-8