PREVALENCE OF METABOLIC SYNDROME AMONG PATIENTS WITH SCHIZOPHRENIA FROM LONG CARE UNIT IN FORENSIC PSYCHIATRY PROGRAM: AN OBSERVATIONAL STUDY
DOI:
https://doi.org/10.21776/ub.jppbr.2024.005.01.1Abstract
Introduction – Metabolic syndrome is a leading health concern among schizophrenia patients treated with antipsychotics. The morbidity and mortality rates of these patients can increase when they already have cardiovascular disease and other risk factors. This study aimed to examine the prevalence of metabolic syndrome and its relationship to various clinical parameters such as blood pressure, fasting blood glucose, triglycerides, high-density lipoprotein, and waist circumference.
Methods – This disease-oriented observational study was carried out in the forensic psychiatric rehabilitation ward at the Erada & Mental Health Complex - Taif, Saudi Arabia. Patients admitted to the inpatient ward between 2018 and 2023 participated in the study (N = 71). The relationship between metabolic syndrome and psychotropic medications was also examined. Schizophrenia was defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria. Metabolic syndrome was assessed based on the international criteria National Cholesterol Education Program’s Adult Treatment Panel III report (ATPIII) criteria and AHA/NHLB.
Results – In this study, 71 volunteer schizophrenic patients were included, and an observational study over five years was conducted. We found the total number of metabolic syndrome patients was 40 (56.34%) compared with 31 (43.66%) patients without metabolic syndrome. The majority of metabolic syndrome patients (57.50%) were aged 41 to 50. The highest number of patients suffering from metabolic syndrome are those taking atypical antipsychotic medications. Among antipsychotic medications, aripiprazole was found the maximum number of 10 (25%) followed by olanzapine 7 (17.5%). Maximum number of metabolic syndrome parameters increased fasting blood sugar 26 (65%) followed by increased body mass index 21 (52.5%).
Discuss – This research can contribute to the study of the prevalence of metabolic syndrome among patients with schizophrenia. In the present study, the prevalence of metabolic syndrome was 56.34 percent in schizophrenia. There are several metabolic side effects associated with second-generation antipsychotics and if these aren't treated properly, they can lead to serious health complications, such as diabetes, dyslipidemia, and fatal heart disease.
Conclusion - In our study, metabolic syndrome was most prevalent among patients between 41 - 50 years of age. Therefore, clinicians are encouraged to screen and monitor metabolic syndrome and treat cardio-metabolic risk factors for optimum long-term management.
Keywords: schizophrenia, metabolic syndrome, antipsychotics.
References
REFERENCES
Rezaianzadeh A, Namayandeh SM, Sadr SM. National Cholesterol Education Program Adult Treatment Panel III Versus International Diabetic Federation Definition of Metabolic Syndrome, Which One is Associated with Diabetes Mellitus and Coronary Artery Disease? Int J Prev Med. 2012; 3(8):552–558. https://pubmed.ncbi.nlm.nih.gov/22973485/
Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract. 2014;2014(943162):1-21. https://doi.org/10.1155/2014/943162.
Mitchell AJ, Vancampfort D, Sweers K, Winkel R van, Yu W, Hert MD. Prevalence of Metabolic Syndrome and Metabolic Abnormalities in Schizophrenia and Related Disorders—A Systematic Review and Meta-Analysis. Schizophr Bull. 2013;39(2):306. https://doi.org/10.1093/schbul/sbr148
Vancampfort D, Correll CU, Galling B, Probst M, De Hert M, Ward PB, et al. Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta-analysis. World Psychiatry. 2016; 15(2):166–174. https://doi.org/10.1002/wps.20309
Goldstein BI, Fagiolini A, Houck P, Kupfer DJ. Cardiovascular disease and hypertension among adults with bipolar I disorder in the United States. Bipolar Disord. 2009; 11(6):657–662. https://doi.org/10.1111/j.1399-5618.2009.00735.x
Grundy SM, Brewer Jr HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the national heart, lung, and blood institute/american heart association conference on scientific issues related to definition. Circulation. 2004; 109: 433-438. https://doi.org/10.1161/01.CIR.0000111245.75752.C6.
Sweileh WM, Zyoud SH, Dalal SA, et al. Prevalence of metabolic syndrome among patients with schizophrenia in Palestine. BMC Psychiatry. 2012; 12: 235. https://doi.org/10.1186/1471-244X-12-235.
Sugawara N, Yasui-Furukori N, Sato Y, et al. Prevalence of metabolic syndrome among patients with schizophrenia in Japan. Schizophr Res. 2010; 123: 244-250. https://doi.org/10.1016/j.schres.2010.08.030.
Hennekens CH, Hennekens AR, Hollar D, Casey DE. Schizophrenia and increased risks of cardiovascular disease. Am Heart J. 2005; 150:1115‑1121. https://doi.org/10.1016/j.ahj.2005.02.007.
De Hert M, Correll CU, Bobes J, Cetkovich‑Bakmas M, Cohen D, Asai I, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications anddisparities in health care. World Psychiatry. 2011;10(1):52‑77. https://doi.org/10.1002/j.2051-5545.2011.tb00014.x.
Siddiqui JA, Qureshi SF, Alghamdi IM, Alotaibi HM. Metabolic syndrome: a psychiatric outlook. Psychosom Med Res. 2023;5(1):1. https://doi.org/10.53388/PSMR2023.
Vancampfort D, Stubbs B, Mitchell AJ, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder, and major depressive disorder: A systematic review and meta-analysis. World Psychiatry. 2015;14(3):339-347. https://doi.org/10.1002/wps.20252.
Bora E, Akdede BB, Alptekin K. The relationship between cognitive impairment in schizophrenia and metabolic syndrome: A systematic review and meta-analysis. Psychol Med. 2017;47(6):1030-1040. https://doi.org/10.1017/S0033291716003366.
Yates KF, Sweat V, Yau PL, et al. Impact of metabolic syndrome on cognition and brain: A selected review of the literature. Arterioscler Thromb Vasc Biol. 2012;32(9):2060-2067. https://doi.org/10.1161/ATVBAHA.112.252759.
De Hert M, van Winkel R, Van Eyck D, Hanssens L, Wampers M, Scheen A, et al. Prevalence of diabetes, metabolic syndrome and metabolic abnormalities in schizophrenia over the course of the illness: A cross‑sectional study. Clin Pract Epidemiol Ment Health. 2006; 2:14. https://doi.org/10.1186/1745-0179-2-14.
Bajaj S, Varma A, Srivastava A, Verma AK. Association of metabolic syndrome with schizophrenia. Indian J Endocrinol Metab. 2013;17(5):890‑895. https://doi.org/10.4103/2230-8210.117238.
Ogbera AO. Prevalence and gender distribution of the metabolic syndrome. Diabetol Metab Syndr. 2010; 2(1):1. https://doi.org/10.1186/1758-5996-2-1.
Tirupati S, Chua L‐E. Obesity and metabolic syndrome in a psychiatric rehabilitation service. Aust NZ J Psychiatry. 2007;41(7):606–610. https://doi.org/10.1080/00048670701392841.
Hatata H, El Gohary G, Abd-Elsalam M, et al. Risk of metabolic syndrome among Egyptian patients with schizophrenia. Curr Psychiatry. 2010;16:85-95. https://psychiatry-research-eg.com/texts/current-psychiatry-v15n3-08/9en.pdf
Isezuo SA, Ezunu E. Demographic and clinical correlates of metabolic syndrome in Native African type 2 diabetic patients. J Natl Med Assoc. 2005, 97 (4): 557-563. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568734/
Ryan MC, Thakore JH. Physical consequences of schizophrenia and its treatment: the metabolic syndrome. Life Sci 2002; 71(3): 239-257. https://doi.org/10.1016/s0024-3205(02)01646-6.
Thakore J, Mann J, Vlahos I, Martin A, Reznek R. Increased visceral fat distribution in drug-naive and drugfree patients with schizophrenia. Int J Obes Relat Metab Disord 2002; 26(1): 137-141. https://doi.org/10.1038/sj.ijo.0801840.
Hanley AJ, Karter AJ, Williams K, et al. Prediction of type 2 diabetes mellitus with alternative definitions of the metabolic syndrome: the Insulin Resistance Atherosclerosis Study. Circulation 2005; 112(24): 3713-3721. https://doi.org/10.1161/CIRCULATIONAHA.105.559633.
Shafie S, Lee SP, Ong SBC, et al. Prevalence and correlates of diabetes mellitus and dyslipidaemia in a long-stay inpatient schizophrenia population in Singapore. Singapore Med J. 2018; 59(9): 465-471. https://doi.org/10.11622/smedj.2018020.

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