Kiran Kumar K

Abstract

Background and Objectives: Bipolar Affective Disorder (BPAD) is a complex, episodic and heterogeneous condition leading to impairment of Quality of life (Qol). The current study was undertaken with the aim to assess the Quality of Life of patients with Bipolar Affective Disorder, compare it with general population and to examine the correlation of socio-demographic and clinical variables with the Quality of Life. Methodology: This was a cross-sectional case-control study. Hundred consecutive patients diagnosed to have BPAD as per ICD-10 currently euthymic who fulfilled the inclusion and exclusion criteria and gave informed consent were included for the study. Fifty healthy controls were selected from the general population after clinical interview. Subjects were administered YMRS and HAM-D followed by assessment of QoL using WHOQOL-BREF (World Health Organization Quality of Life –Brief version). The data was analysed using SPSS package version 15.0. Results: Comparison of the four domain scores of WHOQOL-BREF showed that BPAD patients Qol was significantly impaired than the healthy controls (Physical health, p Conclusion: The emerging body of research has shown that the BPAD has a negative effect on the QoL even during periods of euthymia and remission. A number of socio-demographic and clinical variables have a bearing on the QoL of patients with BPAD. Keywords: Bipolar affective disorder, Quality of life, Remission

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Abstract

Background: Schizophrenia is an enduring severe mental illness with significant morbidity and early excess mortality. Metabolic syndrome (MetS) is a construct that aids psychiatrist to understand this constellation of risk factors leading to premature mortality. The current study was carried out with an aim to understand the association of metabolic syndrome in patients with schizophrenia and also to ascertain its relationship with socio-demographic & clinical variables. Materials and Methods: A cross sectional study was undertaken in patients suffering from Schizophrenia (F20) as per International Classification of Diseases (ICD-10. A total of one-hundred patients were selected by purposive random sampling after obtaining a written informed consent. A predesigned proforma was used to obtain the information regarding the sociodemographic variables, drug intake, anthropometric values and metabolic parameters. Metabolic syndrome was diagnosed as per the International Diabetes Federation- 2006 criteria. The data obtained was analysed using statistical package for social services (SPSS 20). Results: The association of metabolic syndrome in schizophrenia in the current study was 42%. The individual metabolic parameters were found to be higher in the MetS group than the non-MetS group (p=0.001). Majority of the schizophrenia patients with MetS were older (59.5% vs 44.8%; 31-50 years of age) and females (52.4% vs 36.2%; p=0.107) compared to those without MetS. Most of them were married (85.7% vs 56.9%; p=0.006), from urban areas (45.2% vs 19%; p=0.005), had lower educational qualification (p=0.01) in comparison to the non-MetS group. The MetS group had longer mean duration of schizophrenia (9.64±8.1 years vs 3.76±2.29 years), more hospitalizations (66.7% vs 53.4%; p=0.02) and higher medical comorbidity (diabetes-7.1% vs nil, hypertension-9.5% vs 1.7% and hypothyroidism-7.1% vs nil; p=0.006). With respect to psychotropic drugs usage; the use of Olanzapine (69% vs 46.6%; p=0.025), longer duration of treatment with Olanzapine (26.31 ± 33.9 months vs 8.98 ± 12.3; p=0.001) and Amisulpride (11.0 ± 21.68 months vs 3.48 ± 9.9; p=0.022) were significantly associated with MetS group than the group without MetS. On the contrary, the non-MetS group had more patients receiving risperidone (58.6%) than the MetS group. Conclusion: The study shows that the association of metabolic syndrome in schizophrenia patients is significantly in higher percentage and thereby underlines the importance of early detection and treatment of both the disorders simultaneously. Keywords: Cardiovascular disorders, Metabolic syndrome, Schizophrenia, Type 2 diabetes mellitus.

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