The metabolic syndrome in an Italian psychiatric sample: a retrospective chart review of inpatients treated with antipsychotics

Introduction. The metabolic syndrome (MS) is an area of interest for mental health research because individuals with mental illnesses have an increased risk of medical morbidity and mortality compared with the general population. This cross-sectional study is aimed to estimate the prevalence of metabolic syndrome in an Italian psychiatric sample, treated with different types of antipsychotics. Methods. The data were derived from medical records of patient with affective and non-affective psychosis, admitted to the Hospital of L'Aquila psychiatric ward, from January 2012 to July 2014. The sample refers to consecutive admissions of subjects of both sexes, aged over 18 years, receiving one or more antipsychotic treatment. The diagnosis of MS was established when the clinical subject at least three of the five diagnostic criteria of the Adult Treatment Panel (NCEP-ATP III) were met. Results. 389 subjects were evaluated. We report a MS prevalence of 27.5%. This figure is very close to the metabolic syndrome prevalence in the Italian general population quoted around 26%. The BMI values also are very similar in these two populations, despite a higher obesity rate in the clinical sample. The MS prevalence rates in subject with schizophrenia, bipolar disorders and depressive disorders were respectively 30.6%, 36.4% and 36.8%. No significant differences in MS, diabetes or dyslipidemia rates were found among the three diagnostic groups. We did not find differences in metabolic syndrome prevalence either in relation to psychotropic polypharmacy or in relation to typical or atypical antipsychotics. However the psychiatric females in the clinical sample tend to have higher obesity rate, with a sort of all or none distribution (i.e. more obesity, more normal weight, but less overweight) compared to the general population. Conclusions. These findings could be explained by the interaction of some sort of liability due to drug treatment, illness related lifestyles, gender and other interacting factors (e.g. genetic) with metabolic issues.