Anthropometric and Physiological Measures in Individuals With At-Risk Mental State (ARMS) Compared With Individuals With Schizophrenia: Findings From a Lower Middle-Income Country

Abstract

Background

Individuals with psychosis have reduced life expectancy and this is largely driven by cardiometabolic disease. Cardiometabolic risk increases with age and duration of psychotic illness. Anthropometric and physiologic abnormalities have been identified among individuals with at-risk mental state (ARMS) for psychosis. The prevalence of cardiometabolic disease is disproportionately higher in lower middle-income countries (LMIC); however, literature on cardiometabolic disease in individuals with psychosis spectrum disorders in LMIC is scarce.

Method

This is a cross-sectional secondary analysis of data from two large randomised controlled trials that recruited individuals with ARMS (n = 326) and schizophrenia (SCZ; n = 303) from inpatient and outpatient settings in Pakistan. All participants completed anthropometric and physiological assessments.

Results

There was a statistically significant difference in BMI between groups, 21.42 (SD = 4.11) in ARMS and 23.31 (SD = 5.41) in the SCZ group (p = 0.001). Although mean values were within the normal range, 17.8% (n = 58) of ARMS individuals and 33.1% (n = 100) SCZ individuals were overweight or obese. Waist circumference was 32.75 in (SD = 3.13) in the ARMS group and 32.16 in (SD = 5.18) in SCZ. Although waist circumference was higher in ARMS, this was not statistically or clinically significant. The pulse rate and blood pressure in both groups were within normal range.

Conclusion

We found evidence of abnormal anthropometric and physiological parameters that would indicate that individuals with psychotic-spectrum disorders in Pakistan are at an elevated cardiometabolic risk.