Audit of metabolic syndrome in adults prescribed clozapine in community and long-stay in-patient populations

Abstract

Aims and MethodsTo calculate the prevalence of metabolic syndrome in patients receiving clozapine in community and long-stay in-patient settings. Patients were assessed using measures specified by the Expert Panel of the US National Cholesterol Education Program.ResultsThe prevalence of the metabolic syndrome was calculated as 53% in the community groups and 11% in the in-patient group, although both sample sizes (particularly the in-patient group) were small. Women were more frequently affected than men in the community population.Clinical ImplicationsThe higher percentage of metabolic syndrome in the community patients receiving clozapine has implications with respect to physical health. The reasons for the lower percentage in the in-patient group are unclear. Our findings point to a possible difference in the physical health of long-stay psychiatric in-patients and patients in the community.

Prevalence of Metabolic Syndrome in Psychiatric Inpatients: A Naturalistic Study

“…This figure is in keeping with the findings of previous surveys, ranging from 30% -54%, in community psychiatric populations (Mackin et al, 2007;Lamberti et al, 2006;Morgan et al, 2008) and up to 47% in hospitalised patients. (Correll et al, 2006) In contrast, an extensive Finnish birth cohort study estimated the prevalence of metabolic syndrome in a non-psychiatric population to be only 6%, demonstrating the significance of psychiatric illness on physical health parameters.…”

“…(Saari et al, 2005) Morgan's survey, also looking at psychiatric inpatients, detected a much lower rate (11%) than did our study. (Morgan et al, 2008). Although carried out on an inpatient population, this work is not directly comparable to ours as the sample were all long stay inpatients and treated with clozapine.…”

“…This trend has been reported elsewhere in similar studies. (Lamberti et al, 2006), (Morgan et al, 2008) • The data for individual diagnoses was too small to be analysed in detail. However, no major difference in the figures for metabolic syndrome existed when comparing those diagnoses considered under the broad heading of psychoses (schizophrenia, delusional disorder, acute schizophrenia-like psychotic disorder) and those under an affective heading (bipolar affective disorder and depression).…”

“…al, 2007) estimates of its prevalence have been found to be high (up to 54%) in community samples of psychiatric patients on regular antipsychotic medication. (Mackin et al, 2007;Lamberti et al, 2006;Morgan et al, 2008) …”

The prevalence of metabolic syndrome and its association with alanine aminotransferase in clozapine-treated Korean patients with schizophrenia

“…The prevalence in our study is rather high, considering that Taiwanese are Asian (Chuang et al, 2004). A recent report showed that the prevalence of MetS in a long-stay inpatient group was 11%, which was considerably lower than that found in community groups, 53%, although the small size of the sample of inpatients (N = 11) is a limitation of that study (Morgan et al, 2008). However, the inclusion criteria were similar in that the patients were receiving clozapine for at least 3 months at the time the survey was conducted (Bai et al, 2011).…”