Date Published: 15 February 2009

Patients with schizophrenia at increased risk of metabolic syndrome

Patients suffering from schizophrenia and other severe mental illnesses are twice as likely to suffer from metabolic syndrome as the general population, according to the results of a recent study published in the Medical Journal of Australia in the article Prevalence of metabolic syndrome among Australians with severe mental illness.

To be diagnosed with metabolic syndrome, patients needed to have a combination of several specific criteria, such as high blood pressure, a high fasting blood sugar level and abdominal obesity. People with the metabolic syndrome are at increased risk of early coronary heart disease and death.

The study involved 203 patients with a mental illness requiring treatment with an antipsychotic medication seen at the mental health service in metropolitan Perth, Western Australia. It found that 54% of these patients had metabolic syndrome.

Lead author of the study, Dr Alexander John, said the high prevalence of metabolic syndrome in the group ? almost double the prevalence of the Australian population ? is worrying.

?Furthermore, the increasing prevalence was not confined to patients with schizophrenia, but occurred among those with a variety of other psychiatric disorders [including bipolar disorder].?

If these results can be replicated in larger samples in other settings in Australia, this would suggest that major psychiatric illness in general should be considered a risk factor for metabolic syndrome,”Dr John said.

?It would then raise the question of whether vigorous screening for the syndrome should be instituted for people with any form of major psychiatric disorder.?

In a linked editorial, Dr Timothy Lambert of the University of Sydney's Medical School said that the increased likelihood of early heart disease with metabolic syndrome could cut these patients' life expectancy by up to 25 years.

?The alarming rates of premature death in this population confirm the need to closely monitor cardio-metabolic risks for all patients with psychosis.?

Clearly, the mantra of first-episode psychosis services (?early detection and prevention?) applies to physical health as well as psychosis itself,”he said.

The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

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