Metabolic Syndrome, Obesity Not Strongly Linked to Suicidality in Bipolar Disorder

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Researchers examined study data to determine if there was an association between metabolic syndrome and suicidality in patients with bipolar disorder.

Study data published in the Journal of Affective Disorders do not support an association between metabolic syndrome and suicidality in patients with bipolar disorder. In a cohort of patients with bipolar disorder, neither metabolic syndrome nor increased body mass index (BMI) conferred greater risk for suicide ideation or attempt.

The prevalence of metabolic syndrome and overweight/obesity is increased in patients with bipolar disorder. To examine the effects of these factors on suicidality, investigators extracted data from an ongoing cohort study of patients with bipolar disorder in Graz, Austria.

Anthropometric measures, serum lipid levels, and sociodemographic characteristics were extracted. Exposures of interest were BMI category and the presence of metabolic syndrome per the International Diabetes Federation criteria. The primary outcomes were self-reported suicide ideation and suicide attempt. An analysis of covariance was calculated to determine the effects of metabolic syndrome and BMI on suicidality.  

The study cohort comprised 215 patients who had a mean age of 43.9±13.7 years, among whom 104 (48.4%) were women and 111 (51.6%) were men. Mean illness duration was 18.5±11.9 years. Overall, 30.7% patients met the criteria for metabolic syndrome; 75 (34.9%) had an overweight BMI; and 66 (30.7%) had obesity.

In the total cohort, 80.9% reported ever experiencing suicide ideation and 35.3% reported at least 1 suicide attempt. No significant effect of metabolic syndrome was found on suicidality, even after adjusting for age, sex, and illness duration.

Similarly, serum lipid levels were not correlated with risk for patient suicide ideation or attempt. In an analysis of BMI categories, patients with overweight BMI were less likely to report suicide ideation than patients with normal BMI (P =.018). Neither of these groups had significantly different suicidality risk compared with patients with obesity.

Regarding study limitations, authors noted the cross-sectional design and the lack of data on patients’ medication intake.

“The results of this study did not confirm a relationship between MetS [metabolic equivalents] and suicidality in individuals with BD,” the investigators wrote. “Although a difference in [suicidal ideation] was found between BMI classes, further research on this topic is needed to investigate a possible influence of obesity-inducing medication.”


Stenzel C, Dalkner N, Unterrainer HF, et al. Effects of metabolic syndrome and obesity on suicidality in individuals with bipolar disorder. J Affect Disord. Volume 311, 15 August 2022, Pages 1-7. doi: 10.1016/j.jad.2022.05.062

This article originally appeared on Psychiatry Advisor