Prevalence And Risk Factors For Metabolic And Movement Disorders In Patients With Bipolar Disorder In Kenyatta National Hospital And Mathare Referral Hospital

Abstract

Background: Bipolar disorder is one of the most widely investigated psychiatric disorders. Only few patients get minimally adequate treatment, due to social stigma, lack of funds and education. The Pharmacological treatment of bipolar syndromes causes an increase in weight, lipid and glucose metabolism alterations. This increases the risk of cardiovascular syndromes leading to increased mortality and shortens the life expectancy. Movement disorders are also most common among people who take antidepressants, neuroleptics, antipsychotics and mood stabilizer drugs. Study objective: The purpose of this study is to measure the prevalence and risk factors for movement and metabolic disorders among patients on treatment for bipolar disorders at Kenyatta National Hospital and at Mathari Referral Hospital. Methods: The study was a hospital based ambi-directional cross sectional study involving 189 out and in-patients on treatment for bipolar disorders in Kenyatta National Hospital and at Mathari Referral Hospital. All data was collected anonymously and kept confidentially. Descriptive and inferential data analyses have been used to summarize data. Raw data was collected using study tools and entered into a password protected Epi -Info version 7(2007 to 2010) database then exported to STATA version 14 for analysis. The logistic regression used to determine the risk factors. Results: The results found 189 patients with bipolar disorders, males were 107 (57.7%) and females were 82 (42.3%). The prevalence for metabolic disorders was 65.6% included hypertension 83 (43.9%); diabetes 53 (28.03%); obesity 9 (4.8%); overweight 19 (10.1%) and underweight 59.8% (113). The prevalence of movement disorders was: parkinsonism 102 (54%), masked faces 101 (53.4%); reduced arm swing 62 (32.8%); slowed initiation of activities 140 (74.1%); speech 131 (69.3%); abnormal posture 89 (47.1%); rigidity of neck 92 (48. 7%); tremor at rest 145 (76. 7%); tremor on action 105 (55%); focal perioral tremor 35 (18.5%); abnormal gait 74 (39.2%); and hypersalivation 130 (68.8%); The risk factors for movement disorders in Kenyatta National Hospital and Mathari Referral Hospital were as follows: residence; bromazepam; zolpiderm, nifedipine and residence. xiii Conclusion: There was a high prevalence for metabolic and movement disorders in bipolar patients attending and admitted in Kenyatta National Hospital and Mathari Referral Hospital. However there was an association between the metabolic, movement disorders and bipolar disorder.