![Sample our Behavioral Sciences journals, sign in here to start your access, latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/110801/TOC-Subject-Sample-2021-Behavioral-Sciences.jpg"})
ABSTRACT
Seasonal pattern (SP) and metabolic syndrome (MetS) are major contributors to poor outcome in bipolar disorders (BD). Patients with seasonal bipolar depression present increased appetite, carbohydrate cravings, weight gain, and hypersomnia, which can increase the development of MetS. MetS also appears to be associated with seasonal mood changes in the general population. This study examines whether a SP in BD is associated with an increased risk of MetS and its sub-components. One thousand four hundred and seventy-one outpatients with BD were systematically enrolled from 2009 to 2016. Inclusion required a disease duration of at least 5 years, with 486 (33%) patients with SP (SP+) and 985 (67%) without (SP–) according to the DSM IV-TR criteria. When using continuous measures of metabolic components, SP+ patients, as compared to SP–, suffered from higher levels for systolic blood pressure (p = 0.01), low-density lipoprotein cholesterol (p = 0.009), fasting glucose (p = 0.007), triglycerides levels (p = 0.03), a larger abdominal circumference (p = 0.02), and a higher body mass index (p = 0.07). In the covariance analysis, adjusted for gender, age, and bipolar subtype, as well as the number of depressive and hypomanic episode, SP+ patients had a significantly higher level of fasting glucose and higher systolic blood pressure. The frequency of MetS did not differ between groups (21.2% in SP– versus 23.9% in SP+). When using categorical definitions for abnormal metabolic components (International Diabetes Federation criteria), there were no differences between groups, except that SP+ patients were more overweight/obese as compared to SP– patients (55.03% versus 46.7%, respectively; p = 0.002) and tended to have more frequently high fasting glucose (18.2% versus 14.3%, respectively; p = 0.07). MetS was frequent in patients with BD, however not associated with SP. Patients with SP appeared more vulnerable to overweight/obesity and presented with higher levels of MetS subcomponents although these parameters were mainly in the normal range. All patients with BD should benefit from early screening and targeted management of cardio-vascular risk factors.
Acknowledgments
We thank the FondaMental Foundation (www-fondation-fondamental.org) for scientific cooperation in mental health, which is developing a new model for translational research in psychiatry in France and supports the infrastructure of Bipolar Expert Centers. We express all our thanks to the nurses, and to the patients who were included in the present study. We thank Hakim Laouamri, and his team (Stéphane Beaufort, Seif Ben Salem, Karmène Souyris, Victor Barteau and Mohamed Laaidi) for the development of the FACE-BP computer interface, data management, quality control and regulatory aspects.
Declaration of interest
Other authors have no conflicts of interest.
Funding
Dr. P.A. Geoffroy has received travel awards or financial compensation from AstraZeneca, Lundbeck, Menarini France and Otsuka.
Pr. C. Henry has received honoraria and financial compensation as independent symposium speaker from Sanofi-Aventis, Lundbeck, AstraZeneca, Eli Lilly, Bristol-Myers Squibb.
Pr. J.M. Azorin received grants/research support, consulting fees and honoraria within the last three years from AstraZeneca, Janssen Cilag, Lundbeck, Otsuka, Servier, Takeda and Teva.
Dr. S. Gard has received honoraria and financial compensation as independent symposium speaker from Astra Zeneca, BMS and Otsuka.
Pr. J.P. Kahn has received travel awards and honoraria or financial compensation as independent symposium speaker from Lundbeck, Bristol-Myers-Squibb, Otsuka, Janssen.
Pr. M. Leboyer has received honoraria and financial compensation as an independent symposium speaker from AstraZeneca and Servier.
Pr. F. Bellivier has received honoraria and financial compensation as independent symposium speaker from Sanofi-Aventis, Lundbeck, AstraZeneca, Eli Lilly, Bristol-Myers Squibb and Servier.
Ass. Pr. B. Etain has received honoraria and financial compensation as independent symposium speaker from Sanofi-Aventis, Lundbeck, AstraZeneca, Eli Lilly, Bristol-Myers Squibb and Servier.
This research was supported by the Foundation FondaMental, Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP, and by the Investissements d’Avenir program managed by the ANR under reference ANR-11-IDEX-0004-02 and ANR-10-COHO-10-01. This funding source had no role in the study design, data collection, analysis, preparation of the manuscript, or decision to submit the manuscript for publication.
Supplemental data
Supplemental data for this article can be accessed at www.tandfonline.com/icbi.