Metabolic Syndrome in First Manic Episode: A Comparison between Patients with or without Previous Depressive Episode

Objective: The purpose of this study was to investigate, whether an association between metabolic syndrome (MetS) and clinical features and affective temperaments exists or not in first manic episode of bipolar disorder (BD) with or without previous depressive episode. Methods: Diagnosed with dipolar disorder type I according to DSM-IV criteria fifty four patients who were had a least one previous depressive episode (PDE) and 87 patients who were experiencing their first manic episode (FME) evaluated consecutively for inclusion. Comorbid axis I disorders and alcohol or substance use were excluded. NCEP ATP III formulated an operational definition of MetS based on the presence of three or more of the following characteristics: abdominal obesity (waist circumference), hypertriglyceridemia, low HDL or being on an antilipidemic agent, high blood pressure or being on an antihypertensive agent, and fasting hyperglycemia or being on antiglycemic agent. The patients who had been in remission period for at least 8 weeks were evaluated with SCIP-TURK and TEMPS-A. Remission was defined as YMRS score<5. Results: MetS was found to be more frequent in these patients than the patients who didn’t have a PDE. PDE, negative family history, childhood trauma and seasonality are determined as the predictors of MetS. Anxious temperament scores were higher in MetS (+) FME patients of both groups. Irritable temperament scores were higher only in MetS (+) FME patients without PDE group. Conclusion: The presence of MetS seems to be correlated with the onset and progression of BD. This may also contribute to the discovery of biological markers, increase in our diagnostic tools, development of protective and individual-spesific treatment options.