Clin Psychopharmacol Neurosci 2018; 16(3): 310-315  
Does Blood Flow Change according to Mood? Blood Rheology in Bipolar Disorder
Tevfik Kalelioglu1, Murat Kocabiyik2, Burcu Kok1, Pelin Unalan1, Sule Sozen1, Ozge Yuksel1, Nesrin Karamustafalioglu1
1Department of Psychiatry, Bakırköy Mental Health Research and Teaching Hospital, Istanbul, 2Department of Biochemistry, Bingöl State Hospital, Bingöl, Turkey
Correspondence to: Tevfik Kalelioglu, MD
Department of Psychiatry, Bakırköy Mental Health Research and Teaching Hospital, Zuhuratbaba Mah. Dr.Tevfik Sa?lam Cad. No:25/2 , Istanbul 34147, Turkey
Tel: +90-212-543-6565, Fax: +90-212-409-1595
E-mail: tevfikkaleli@hotmail.com
ORCID: https://orcid.org/0000-0001-9319-055X
Received: June 20, 2017; Revised: September 2, 2017; Accepted: September 26, 2017; Published online: August 31, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective: Bipolar disorder (BD) is associated with increased rates of cardiovascular diseases. There is growing evidence that blood viscosity may have a common role, correlated with well-known major risk factors that promote cardiovascular disease. In this study we aimed to investigate the whole blood viscosity (WBV) in different stages of BD.
Methods: A total of 121 bipolar patients and 41 age-gender matched healthy controls were included. Forty-four of bipolar patients were in manic, 35 were depressed and 42 were in euthymic state. WBV was calculated from hematocrit and total plasma protein according to Simone’s formula at low and high shear rates (LSR and HSR).
Results: WBV at HSR of manic group was 16.91±1.01, depressive group was 17.23±0.80, euthymic group was 17.63±0.95, and control group was 17.52±0.71 (p =0.001). WBV at LSR of manic depressive, euthymic and control group were 53.10±20.58, 60.30±17.02, 8.91±20.33, and 62.01±19.28, respectively (p =0.001). Both WBV at HSR and LSR of manic group was significantly lower than that of the euthymic and control groups (p =0.001 and 0.010 respectively for HSR, p =0.001 and 0.011 respectively for LSR). WBV was significantly positively correlated with lipid profile except high density lipoprotein (HDL).
Conclusion: Our results demonstrate a decrement in blood viscosity in manic episode compared with euthymics and controls. Positive correlation of blood viscosity with lipid parameters (except HDL), and negative correlation with number of previous manic episodes suggest that manic episode has favorable effect on cardiovascular risk regarding to blood viscosity.
Keywords: Blood viscosity; Bipolar disorder; Cardiovascular risk.


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