The prevalence of metabolic syndrome among psychiatric inpatients in Brazil

Abstract

A b s t r a c t Objective: Metabolic syndrome is a highly prevalent disorder among the general population. Studies show an even higher prevalence among psychiatric patients. The objective of this study is to assess the prevalence of metabolic syndrome among inpatients of a psychiatric ward of a general hospital in Brazil and correlate it with their respective psychiatric diagnoses and with the antipsychotics and mood stabilizers used. Method: 170 inpatients (mean age: 45.6 years) were evaluated according to the National Cholesterol Education Program criteria for metabolic syndrome, with a modification of the criteria for blood pressure and fasting glucose. Results: The prevalence found was 29.4%, being higher in women (43.6% versus 20.8%, p = 0.002). The prevalence stratified by psychiatric diagnostic was 48.1% for depression, 38.3% for bipolar disorder, 31.8% for schizophrenia and schizoaffective disorder, 5.1% for alcoholism, and 23.1% for "other mental disorders". The prevalence for alcoholism was significantly lower than the prevalence rates associated with other diagnostic categories (p = 0.035). After using the multivariate analysis, female gender and use of lithium remained as factors associated with a diagnosis of metabolic syndrome. Conclusions: The prevalence found was 29.4%. Gender (female) and use of lithium were factors significantly associated with the diagnosis of metabolic syndrome.Descriptors: Metabolic syndrome X; Mental disorders; Schizophrenia; Bipolar disorder; Depression Resumo Objetivo: A síndrome metabólica é um transtorno de alta prevalência na população em geral. Estudos demonstram prevalência ainda maior em pacientes psiquiátricos. O objetivo deste trabalho é avaliar a prevalência de síndrome metabólica em pacientes internados em uma enfermaria psiquiátrica de um hospital geral no Brasil e correlacioná-la com os diagnósticos psiquiátricos e com o uso de medicamentos antipsicóticos e moduladores do humor. Método: Cento e setenta pacientes (idade média: 45,6 anos) foram avaliados de acordo com os critérios do National Cholesterol Education Program para síndrome metabólica, modificados nos critérios pressão arterial e glicemia de jejum. Resultados: A prevalência encontrada foi de 29,4%, sendo mais elevada em mulheres (43,6% versus 20,8%, p = 0,002). A prevalência estratificada por diagnóstico psiquiátrico foi de 48,1% para depressão, 38,3% para transtorno bipolar, 31,8% para esquizofrenia e transtornos esquizoafetivos, 5,1% para alcoolismo e 23,1% para "outros transtornos mentais". A prevalência para alcoolismo foi significativamente menor, se comparada às prevalências associadas às demais categorias diagnósticas (p = 0,035). Após análise multivariada, o sexo feminino e o uso de lítio permaneceram como fatores associados ao diagnóstico de síndrome metabólica. Conclusão: A prevalência de síndrome metabólica encontrada foi de 29,4%. O sexo feminino e o uso de lítio foram fatores significativamente associados ao diagnóstico de síndrome metabólica.

Comparison of metabolic parameters and Framingham cardiovascular risk scores before and after in‐hospital treatment with antipsychotics

“…myocardial infarction, sudden cardiac death and stroke) [5]. This applies not only to antipsychotics, but also to mood stabilizers [6] and antidepressants [7]. Treatment-induced metabolic disorders may account for dradra-ramatically increased mortality of schizophrenia patients [8].…”

Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

“…1 Patients with BD are subject to premature death from all causes when compared to the general population 2 and usually have several comorbid general medical conditions associated with worse outcomes and higher burden of disease. [3][4][5] Increased rates of obesity, 6,7 diabetes, 8 hypertension, 9 dyslipidemia, 10 and metabolic syndrome [11][12][13] have been reported in recent clinical and epidemiological studies. 14,15 In addition to being exposed to the weight gain effects of the pharmacological treatment, BD patients are more likely to have sedentary lifestyles and poor dietary habits, 16 which are well-established cardiovascular risk factors.…”

Effect of metabolic abnormalities on cognitive performance and clinical symptoms in schizophrenia

“…They are effective, yet current researches indicate that metabolic abnormalities (usually named as metabolic syndrome) may be more frequent in patients treated with antipsychotics (particularly of second-generation) comparing to general population [1]. However, this applies not only to antipsychotics, but also to mood stabilizers [2] and antidepressants [3], so these are common consequences for all major psychopharmacological drugs used nowadays. Therefore, patients with psychiatric disorders may have increased mortality resulting from increased risk of cardiovascular events (e.g.…”