Psychotic disorders associated with metabolic syndrome features

NEW YORK (Reuters Health) – The results of a study published in the July issue of the Journal of Clinical Psychiatry suggest an association between non-affective psychotic disorders and abdominal obesity and lipid and glucose abnormalities.

Dr. Jaana M. Suvisaari, of the National Public Health Institute, Helsinki, Finland, and colleagues, conducted a general population study in which they examined the prevalence of metabolic syndrome and its components in a nationally representative, 2-stage cluster sample of 8028 Finnish subjects at least 30 years of age.

The field work for the study was conducted between September 2000 and June 2001. A home interview and a health examination were performed, and laboratory and other measurements related to metabolic syndrome were taken. The subjects were instructed to fast for at least 4 hours before the examination. The team estimated prevalence of metabolic syndrome, adjusting for age, sex, and hours of fasting.

Significantly higher fasting plasma glucose and triglyceride levels were observed in patients with schizophrenia compared to the rest of the study population. Schizophrenic patients also had lower HDL cholesterol levels, a larger waist circumference, and lower systolic blood pressure.

Patients diagnosed with other non-affective psychotic disorders had larger waist circumference and higher body mass index. Those with affective psychoses had lower systolic blood pressures.

The prevalence estimates of metabolic syndrome among subjects with schizophrenia, non-affective psychotic disorder, and affective psychosis were 36.2%, 41.4%, and 25.0%, respectively, compared with 30.1% among those without psychotic disorders.

The prevalence of metabolic syndrome was also significantly higher among users of high-potency antipsychotics (52.1%, p < 0.001) compared with the total sample. The metabolic syndrome prevalence was not significantly elevated among users of low-potency or atypical antipsychotic medications.

Based on these findings, the researchers conclude: "Regular monitoring and active treatment of metabolic abnormalities are essential in this patient population."

J Clin Psychiatry 2007;68:1045-1055.