Endocrinology and Metabolic Disorders

According to Vancampfort et al.’s meta-analysis, antipsychotic use significantly explained higher MetS prevalence estimates in major depressive disorder (MDD), (2013b). Differences in MetS prevalences were not mediated by age, gender, geographical area, smoking, antidepressant use, presence of psychiatric co-morbidity. In another study, there was some mediating role for tricyclic and non-selective serotonin-reuptake inhibitor antidepressant use but overall, the mediating role of clinical differences were limited (Luppino et al. 2014). When Margary et al. evaluated 83 psychiatric inpatients diagnosed with schizophrenia, bipolar disoreder and MDD they found a positive association between antidepressant drug treatment with triglycerides, and triglycerides/HDL ratio levels and antipsychotics drugs with the HOMA and Framingham index (2013). In Perugi et al.’s study, duration of pharmacological treatment and age at onset of first major episode were associated with the presence of comorbid MetS (2015). Time of onset for affective disorders and medical conditions were relatively concurrent. When comorbidity of medical conditions were evaluated in terms of phases of bipolar disorder, possibly they are more prevalent at onset and earlier episodes. This is because early mortality is observed more in patients with earlier onset (Goldstein et al. 2009). Comorbid medical conditions that emerge in middle stages of bipolar disorder would possibly be related to the effect of treatment and effects of patient’s habits and lifestyle. However it was showed that even in these circumstances they emerge one decade earlier than the age-matched subjects without bipolar disorder. When all these findings are taken together, it seems that MetS is one of the variables which is in a position as both an initiator and an outcome of bipolar disorder.