Overweight and obesity in patients with bipolar disorder or schizophrenia compared with a non-psychiatric sample Manuel Gurpegui a, b, ⁎, José María Martínez-Ortega a, b , Luis Gutiérrez-Rojas a, c , Juan Rivero d , Cristina Rojas b, c , Dolores Jurado a, e a CTS-549 Research Group, Institute of Neurosciences, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain b Department of Psychiatry, University of Granada, Spain c Psychiatry Service, San Cecilio University Hospital, Granada, Spain d Granada-Sur (Zaidín) Community Mental Health Center, San Cecilio University Hospital, Granada, Spain e Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain abstract article info Article history: Received 15 November 2011 Received in revised form 23 January 2012 Accepted 29 January 2012 Available online 3 February 2012 Keywords: Bipolar disorder Body mass index (BMI) Obesity Overweight Schizophrenia Objective: Multiple studies suggest an association of overweight and obesity with bipolar disorder (BD) and schizophrenia. The goal of this paper was to determine the magnitude of this association and its relationship with previous course-of-illness and other variables of clinical interest. Methods: The prevalence of overweight and obesity was compared among patients with BD (n=108), patients with schizophrenia (n=250) and a non-psychiatric control group (n=290). Moreover, within each group we analyzed the variables associated with overweight [including obesity, i.e., body mass index (BMI) ≥25] and obe- sity (BMI ≥30) adjusting for a possible confounding effect of sex, age and educational level by logistic regression. Results: In comparison with the non-psychiatric sample, a strong association of both BMI ≥25 and obesity was observed with BD and schizophrenia (adjusted odds ratios between 3.4 and 4.6; P-values b 0.001). Overweight was significantly associated with male sex and increasing age in both control and BD groups; and with female sex among schizophrenia patients. Moreover, for BD patients, earlier onset of first BD symptoms, presence of a non-psychiatric illness, current use of mood-stabilizing medication, and being a non-smoker were significantly associated with overweight; and male sex and the presence of a non-psychiatric illness, with obesity. Within the schizophrenia patients, obesity was significantly associated with female sex, intermediate age range and lower PANSS score. Conclusions: Among patients with BD or schizophrenia, the chronic course of their illness and their current treat- ment with psychotropic medication might be more relevant for becoming overweight or obese than the specific psychiatric illness. © 2012 Elsevier Inc. All rights reserved. 1. Introduction The growing prevalence of overweight and obesity in developed countries constitutes a noteworthy public health problem. Previous studies among general populations suggest that overweight or obesity bears a significant association with suffering from non-specific psychi- atric morbidity (Kivimäki et al., 2009a) or specific psychiatric disorders (Mather et al., 2009; Petry et al., 2008; Simon et al., 2006; Susce et al., 2005). Indeed, obesity has been related with schizophrenia (Carpiniello et al., 2008; Coodin, 2001; Kolotkin et al., 2008; Saarni et al., 2009), depression (Mather et al., 2009; McIntyre et al., 2006; Simon et al., 2006; Stunkard et al., 2003; Susce et al., 2005), bipolar dis- order (BD) (Kolotkin et al., 2008; Maina et al., 2008; Sicras et al., 2008; Simon et al., 2006; Susce et al., 2005), anxiety disorders (Gariepy et al., 2010; Simon et al., 2006), suicidal conduct (Dong et al., 2006; Mather et al., 2009) and personality disorders (Petry et al., 2008). At the same time, substance abuse has been associated with a lower rate of obesity, both in the general population (Mather et al., 2009; Simon et al., 2006) and in psychiatric patients (Susce et al., 2005). Furthermore, patients with severe mental disorder—when com- pared with the non-psychiatric population—are at a greater risk of smoking (de Leon and Diaz, 2005) and suffering from diabetes, hyper- tension and dyslipidemia (Correll et al., 2008; García-Portilla et al., 2008; McElroy et al., 2002; McEvoy et al., 2005; Newcomer, 2007; Sicras et al., 2008). These latter three conditions, together with abdom- inal obesity, conform the so-called metabolic syndrome which increases the risk of cardiovascular diseases among psychiatric patients. Newcomer (2007) showed that, as opposed to the general population, Progress in Neuro-Psychopharmacology & Biological Psychiatry 37 (2012) 169–175 Abbreviations: BD, bipolar disorder; BMI, body mass index; PANSS, Positive and Negative Syndrome Scale; GHQ, general health questionnaire; OR, odds ratio; CI, confi- dence intervals. ⁎ Corresponding author at: Department of Psychiatry, Facultad de Medicina, Universidad de Granada, Av. Madrid 11, E-18071 Granada, Spain. Tel.: +34 958 240704; fax: +34 958 240730. E-mail address: gurpegui@ugr.es (M. Gurpegui). 0278-5846/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.pnpbp.2012.01.014 Contents lists available at SciVerse ScienceDirect Progress in Neuro-Psychopharmacology & Biological Psychiatry journal homepage: www.elsevier.com/locate/pnp