Prevalence of metabolic syndrome in patients of a community mental health center

Objective: Metabolic syndrome (MetS) is a public health problem with high morbidity and mortality with cardiometabolic complications increasingly common all over the world. The prevalence of MetS is 25-31% in American Society. In our country, the prevalence of MetS is between 33.9 and 41.4% in the normal population. In psychiatric diseases like schizophrenia or bipolar diseases, the MetS risk is high and for the prevalence, a broad range of 5.6-63% has been given. Recent studies show that MetS prevalence is 18.9-42.5% in schizophrenia in our country. We researched the prevalence of MetS among patients who are taking antipsychotics in a community mental health center. Our aim was to detect and prevent MetS to reduce patients morbidity and mortality.

Methods: We searched chronic psychiatry patient files retrospectively for the period of March 2012-November 2014 in a community mental health center.

Results: There were 205 patients, including 82 (40%) female and 123 (60%) male. 121 (59%) of the patients were diagnosed with schizophrenia, 74 (36.1%) of patients diagnosed with bipolar disorder and 10 (4.9%)with schizoaffective disorder. In females, the average of HDL was 54.1, triglyceride 166.8, glucose 118, waist circumference 106.2 and systolic-diastolic blood pressure 117.4-77.6, in males,the average of HDL was 43, triglyceride 196, glucose 102.9, waist circumference 103 and systolic-diastolic blood pressure 120-79.1. The most used antipsychotic was olanzapine (23.9%), followed by aripiprazole (19%); the third one was quetiapine (6.6%), the fourth one clozapine (11.2%), the fifth risperidone (10.7%). There were 57 cases (27.8%) of MetS among 205 patients, 26 (45.6%) of them female, 31 (54.3%) of them male.

Conclusion: It has been indicated that MetS is more common in chronic psychiatric diseases than in the community overall. Genetic and environmental factors can cause MetS; its basic physiopathology includes insulin resistance and fatty tissue malfunctions. Patients who are treated with antipsychotics can experience weight gain, glucose metabolism abnormalities, prediabetic formation or diabetes. These adverse effects, individually or jointly, can cause MetS and cardiovascular diseases. Cardiovascular diseases are one of the common causes of early death in psychiatric diseases like schizophrenia and bipolar disorder. It is important to recognize MetS and its changeable components, as it can also be curable. Clinicians treating schizophrenia or bipolar disorder with antipsychotics must be careful about metabolic changes. Metabolic parameters such as HDL, triglyceride, blood arterial pressure, glucose, or waist circumference can easily be measure and thus morbidity and mortality of MetS and cardiovascular diseases can be reduced.