Bipolar Bozukluk Hastalarında Metabolik Sendrom ve Dürtüsellik İlişkisi

Amaç: Bipolar bozukluk (BB) hastalarında metabolik sendrom (MetS) genel popülasyona göre daha sık görülmektedir. MetS gelişimine etki eden birçok risk etkeni vardır. Dürtüselliğin de dolaylı yollardan obezite ve kan basıncı gibi MetS parametrelerinde artış yarattığı çeşitli çalışmalarda gösterilmiştir. Bu araştırma, MetS ek tanısına sahip BB hastalarında daha yüksek dürtüsellik gözlenebileceği hipotezi üzerine kurulmuştur. BB hastalarında sık görülen MetS’ye ilgi çekmek, MetS ile dürtüsellik bağlantısını diğer olası ilişkili parametreleri de göz önünde bulundurarak incelemek ve bu konudaki alan yazın bilgisine katkı sağlamak amaçlanmıştır. Yöntem: Bu çalışmada, Trakya Üniversitesi Hastanesi Psikiyatri Polikliniği’ne başvuran remisyondaki 125 BB hastası değerlendirmeye alınmıştır. Hastaların MetS parametreleri Amerikan Ulusal Kolesterol Eğitim Programı Üçüncü Erişkin Tedavi Paneli ölçütlerine göre taranmıştır. Hastalara yapılandırılmış psikiyatrik görüşme, Young-Mani Derecelendirme Ölçeği, Hamilton Depresyon Değerlendirme Ölçeği, Barratt Dürtüsellik Ölçeği-11 (BDÖ-11), Memphis, Pisa, Paris ve San Diego Mizaç Değerlendirme Anketi ve Uluslararası Fiziksel Aktivite Formu uygulanmıştır. Bulgular: Hastanemize başvuran BB hastalarında MetS yaygınlığı %56 olarak saptanmıştır. Geriye doğru adımsal regresyon modeli ile total BDÖ11 puanı (OR=1.073, %95 güven aralığı 1.021-1.128, p=0.005) ve hastaların gün içi oturarak geçirdikleri süre (OR=1.073, 95% güven aralığı 1,021-1,128, p=0,005) MetS’li hastalarda istatistiksel olarak artmış saptanmıştır. Tartışma: Çalışmamızın sonuçlarına göre, BB tanılı hastalarda MetS yaygınlığının sık olduğu, yüksek dürtüsellik ve sedanter yaşam tarzına sahip BB hastalarının daha yüksek MetS riski taşıdıkları belirlenmiştir. (Anadolu Psikiyatri Derg 2020; 21(3):277-284)

The Relationship Between Metabolic Syndrome and Impulsivity in Patients with Bipolar Disorder

Objective: Metabolic syndrome (MetS) is highly prevalent in people with bipolar disorder (BD), comparing to the general population. There are many risk factors effecting the development of MetS. Impulsivity has been shown to increase MetS parameters such as obesity and blood pressure indirectly in various studies. This study is based on the hypothesis that higher impulsivity may be observed in BB patients with comorbid MetS. The aim of this study is to draw attention to MetS, which is quite common in patients with BD, to examine the relationship between impulsivity and MetS by considering other possible related parameters and to contribute to the literature knowledge in this field. Methods: This study analyzed 125 bipolar patients in remission at psychiatry outpatient clinic of Trakya University Hospital. MetS parameters of patients were evaluated according to American National Cholesterol Education Program Third Adult Treatment Panel criteria. The Structured Clinical Interview, Young-Mania Rating Scale, Hamilton Depression Rating Scale, Barratt Impulsivity Scale 11 (BDI-11), Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire, the International Physical Activity Questionnaire were applied to the patients. Results: The prevalence of metabolic syndrome in bipolar patients was 56% in our hospital. A backward stepwise logistic regression model showed that the total score of the BDI 11 (OR=1,192, 95% confidence interval 1.006-1.412, p=0.042) and daily sitting time of patients (OR=1.073, 95% CI 1.021-1.128, p=0.005) was significantly higher in bipolar patients with metabolic syndrome. Discussion: According to the results of our study, the prevalence of MetS is common in patients with BD and patients with BD who have higher impulsivity and sedentary life style have higher risk of metabolic syndrome. (Anatolian Journal of Psychiatry 2020; 21(3):277-284)

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