Compared to the general population, patients with major mental disorders have a higher prevalence of metabolic syndrome (MetS), which is known to increase cardiovascular risk and mortality. Many factors contribute to development and maintenance of metabolic disturbances in psychiatric patients. Nevertheless, gaps remain in relevant aspects, encouraging further studies in specific subgroups to evaluate the impact of each variable in developing MetS. Our aim is to identify the clinical and sociodemographic features consistently associated with the occurrence of MetS in a sample of inpatients affected by severe and acute mental illness.
Our study had a naturalistic design and involved inpatients consecutively admitted to the Psychiatric Unit of ‘S Luigi Gonzaga Hospital’ of Orbassano from December 2013 to September 2014. At study entry, general sociodemographic and clinical information was collected for each subject, including lifestyles and comorbidity for cardiovascular diseases and diabetes. Through index visit and routine blood exam, all metabolic parameters were assessed to define the presence of MetS according to NCEP ATP III modified criteria. Sociodemographic and clinical correlates of MetS were then investigated.
One hundred twenty-five patients were enrolled. Of these, 37 (29.6%) had schizophrenia spectrum and other psychotic disorders, 47 (37.6%) had bipolar and related disorders, 28 (22.4%) had depressive disorders and 13 (10.4%) had personality disorders.
MetS was present in 35.2% of the sample. Low HDL-C levels were the most frequently endorsed criterion, present in 57.6% of subjects. Abdominal obesity, high triglycerides, hypertension and fasting hyperglycaemia were observed in 51.2%, 30.4%, 28.8% and 20% of patients, respectively. Patients who fulfilled MetS definition were more often characterised by current atypical antipsychotic treatment, current alcohol abuse, current psychiatric comorbidity with substance related disorders and longer duration of illness. After performing regression analysis, only current atypical antipsychotic treatment was significantly associated to MetS.
Our study confirms the increased risk of MetS in patients treated with atypical antipsychotics. No other clinical or sociodemographic variables were associated with MetS. These findings suggest a shared susceptibility to antipsychotic-related metabolic dysregulation that is not primarily related to psychiatric diagnosis or concomitant to other psychiatric treatment.