Patients with bipolar disorder may be at elevated risk for metabolic syndrome or its components. Little is known about awareness of metabolic issues among European psychiatrists, or the impact on management of bipolar disorder.

In 2006, 718 psychiatrists in UK, France, Germany, Spain and Italy were recruited to complete an online survey. Eligibility criteria were: practicing 4-30 years, spending ≥50% of time in direct patient care, and treating ≥10 bipolar patients in the last month. Aggregate data were weighted according to the number of psychiatrists in each country. Data comparing individual countries were not weighted due to possible biasing factors such as demographic differences.

22% of respondents were unfamiliar with metabolic syndrome. More than half (56%) had diagnosed it and 72% saw it as a significant health risk. Based on NCEP criteria, the estimated prevalence was ~25% in bipolar patients and ~20% in the general population. With bipolar medications, side effects of greatest concern to psychiatrists were weight gain, cognitive impairment, and glucose intolerance. Treatments associated with increased risk of metabolic syndrome were olanzapine (76%), risperidone (42%), and quetiapine (36%). Although 39% said metabolic concerns rarely or never lead them to stop or switch bipolar disorder therapies, 65% have changed their interviewing and monitoring habits in the past 3 years regarding metabolic health.

European psychiatrists view metabolic syndrome as prevalent and are concerned about the metabolic risks of bipolar medications. Two thirds say that metabolic health issues have prompted changes in patient care in recent years.