Sindrome metabolica, disturbi dello spettro schizofrenico e trattamenti. Risultati di uno studio naturalistico

Abstract

Introduction

Our aim was to estimate the prevalence of the metabolic syndrome (MS) among outpatients with schizophrenic-spectrum disorders who were receiving antipsychotic drugs.

Materials and methods

A retrospective study was conducted in a community-based public health clinic for psychiatric outpatients in southern Italy. NCEP ATP-III criteria for diagnosis of MS were evaluated by means of questionnaires, physical examination, and laboratory analyses in 134 outpatients (males/females: 72/62; mean age 45.4 ± 13.8 years; range 18-74 years). All had DSM-IV-TR based diagnoses of schizophrenia or a schizophreniform or schizoaffective disorder and had been on first- and/or second-generation antipsychotic (FGA and SGA) drug therapy for at least 12 weeks (mean 45.1 months).

Results

52/134 (38.8%) patients (61.5% of the women vs 38.5% of the men) met the criteria for MS. The most commonly observed manifestations were abdominal obesity (prevalence 92.3%, more common in women); hypertriglyceridemia (76.9%); and systolic hypertension (73.1%, more common in men). Only 22.4% of the patients were receiving antihypertensive treatment, 10.4% were on hypoglycemic therapy, and 2.9% were on lipid-lowering drugs. MS prevalence was not significantly related to treatment, but the group on FGA had significantly higher rates of hyperglycemia and low HDL cholesterol; the latter was also more common in patients on combined FGA-SGA therapy, as were systolic and diastolic hypertension and obesity.

Conclusions

Our findings confirm a high prevalence of MS among subjects with schizophrenia. No significant relation between MS and treatment class emerged, but obesity and hypertension were more common in patients on combined FGA-SGA therapy. The low percentages of patients receiving therapy for hypertension, hyperglycemia, and/or dyslipidemia suggest that greater emphasis needs to be placed on the physical health of these patients.