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三级医院双相情感障碍患者代谢综合征的患病率及其与临床相关因素和照顾者负担的关联

Prevalence of Metabolic Syndrome and Its Association With Clinical Correlates and Caregiver Burden in Patients With Bipolar Disorder at a Tertiary Hospital.

作者信息

Antony Prince, S Neethu, Mathew Kathleen A, Menon Bindu

机构信息

Psychiatry, Amrita Institute of Medical Sciences and Hospital, Kochi, IND.

出版信息

Cureus. 2024 Oct 23;16(10):e72211. doi: 10.7759/cureus.72211. eCollection 2024 Oct.

Abstract

INTRODUCTION

Metabolic syndrome is a cluster of metabolic abnormalities, including obesity, insulin resistance, dyslipidemia, and hypertension. The prevalence of metabolic syndrome is recognized to be high among patients with bipolar disorder. This study is relevant given the limited number of Indian studies exploring the prevalence of metabolic syndrome and its association with clinical correlates in bipolar patients. This research aims to inform clinicians about the need for timely interventions in diagnosing and managing metabolic syndrome in this population, which may contribute to significant morbidity and poor clinical outcomes.

METHODS

A cross-sectional study was conducted in the inpatient and outpatient units of the psychiatry department involving 83 subjects diagnosed with bipolar disorder. Informed consent was obtained, and sociodemographic and clinical data were collected. The National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATP III) criteria were used to diagnose metabolic syndrome. The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAM-D) were applied to assess the severity of manic and depressive episodes, respectively. The Suicide Behaviors Questionnaire-Revised (SBQ-R) was used to assess suicidal risk, and the Burden Assessment Schedule (BAS) was utilized to evaluate caregiver burden. Statistical significance was tested using the independent-sample t-test and Mann-Whitney U test for continuous variables, along with the chi-square test for categorical variables. A p-value of <0.05 was considered significant.

RESULTS

Metabolic syndrome was noted in 49 (59%) patients with bipolar disorder. Subjects with metabolic syndrome exhibited more severe manic episodes, had a higher number of lifetime episodes, were more likely to have a history of suicide attempts, and showed increased suicidal risk. Patients on polypharmacy were at higher risk of developing metabolic syndrome. Caregivers of patients with metabolic syndrome reported greater caregiver burden compared to those without the condition.

CONCLUSION

There is a high prevalence of metabolic syndrome in patients with bipolar disorder. Metabolic syndrome is associated with adverse prognostic factors, including a higher number of lifetime episodes, greater severity of manic episodes, and increased suicidality. This underscores the necessity for routine monitoring of blood and anthropometric parameters.

摘要

引言

代谢综合征是一组代谢异常,包括肥胖、胰岛素抵抗、血脂异常和高血压。双相情感障碍患者中代谢综合征的患病率较高。鉴于探索双相情感障碍患者代谢综合征患病率及其与临床相关因素关联的印度研究数量有限,本研究具有重要意义。本研究旨在告知临床医生,对这一人群的代谢综合征进行诊断和管理时及时干预的必要性,因为代谢综合征可能导致显著的发病率和不良临床结局。

方法

在精神科的住院部和门诊部进行了一项横断面研究,纳入83名被诊断为双相情感障碍的受试者。获得了知情同意,并收集了社会人口学和临床数据。采用美国国家胆固醇教育计划(NCEP)成人治疗专家组第三次报告(ATP III)标准诊断代谢综合征。分别应用青年躁狂评定量表(YMRS)和汉密尔顿抑郁评定量表(HAM-D)评估躁狂和抑郁发作的严重程度。使用自杀行为问卷修订版(SBQ-R)评估自杀风险,并采用负担评估量表(BAS)评估照料者负担。对连续变量使用独立样本t检验和曼-惠特尼U检验进行统计学显著性检验,对分类变量使用卡方检验。p值<0.05被认为具有显著性。

结果

83名双相情感障碍患者中有49名(59%)被诊断为代谢综合征。患有代谢综合征的受试者躁狂发作更严重,终生发作次数更多,更有可能有自杀未遂史,且自杀风险增加。联合使用多种药物的患者发生代谢综合征的风险更高。与没有代谢综合征的患者相比,代谢综合征患者的照料者报告的照料负担更大。

结论

双相情感障碍患者中代谢综合征的患病率较高。代谢综合征与不良预后因素相关,包括更多的终生发作次数、更严重的躁狂发作以及自杀倾向增加。这突出了常规监测血液和人体测量参数的必要性。

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