Metabolic syndrome in patients diagnosed with affective disorders: a cross-sectional study among inpatients from two Cluj-Napoca psychiatry clinics.

Background: Metabolic syndrome (MetS) is highly prevalent among individuals with affective disorders and contributes substantially to premature cardiovascular morbidity and mortality. However, the relative contribution of demographic characteristics, psychiatric diagnosis, and psychotropic medication to metabolic risk remains incompletely understood. This study investigated the prevalence of MetS and its associated demographic, clinical, and treatment-related factors in hospitalized patients with major depressive disorder (MDD) and bipolar disorder (BD). Methods: A cross-sectional study was conducted in 502 adult psychiatric inpatients diagnosed with MDD or BD. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Demographic characteristics, psychiatric diagnosis, metabolic parameters, and psychotropic medication were analyzed. Independent correlates of MetS were identified using multivariable binary logistic regression, excluding variables constituting the diagnostic criteria for MetS to avoid circularity. Results: Metabolic syndrome was identified in 25.4% of the study population. Patients with MetS were significantly older and more frequently female than those without MetS (both p < 0.001). Although bipolar disorder was not significantly associated with MetS in univariate analyses, it became independently associated with MetS after multivariable adjustment (adjusted OR 1.77, 95% CI 1.04-3.02; p = 0.037), together with increasing age (adjusted OR 1.06 per year, 95% CI 1.04-1.08; p < 0.001) and female sex (adjusted OR 1.87, 95% CI 1.18-2.98; p = 0.008). Current psychotropic medication, assessed at the time of hospital admission, was not independently associated with MetS after adjustment for demographic and clinical characteristics. These findings should not be interpreted as evidence against the established long-term metabolic effects of psychotropic medication. Conclusions: Metabolic syndrome represents a common medical comorbidity among hospitalized patients with affective disorders. Increasing age, female sex, and bipolar disorder were independently associated with MetS, whereas current psychotropic medication, assessed cross-sectionally at hospital admission, was not independently associated with metabolic syndrome after adjustment. This finding should be interpreted in the context of unavailable information regarding cumulative treatment exposure, duration, dosage, and previous medication history. These findings support routine metabolic monitoring as an integral component of psychiatric care, particularly among older adults, women, and patients with bipolar disorder.