Metabolic profile and indices in a sample of drug-naive patients with schizophrenia and bipolar disorder

Abstract

BACKGROUND: Patients with mental illnesses such as schizophrenia and bipolar disorder have an increased prevalence of metabolic syndrome (MetS) and its components, risk factors for cardiovascular disease, and type 2 diabetes. Although the prevalence of obesity and other risk factors such as hyperglycemia are increasing in the general population, patients with major mental illnesses have an increased prevalence of overweight and obesity, hyperglycemia, dyslipidemia, hypertension, and smoking, and considerably greater mortality compared with the general population. OBJECTIVES: The main objective of this study is to determine the development of MetS in a sample of drug-naive patients with schizophrenia and bipolar affective disorders compared with a matched control group and to identify the significant criteria and risk factors of developing MetS. PATIENTS AND METHODS: This was a cross-sectional case-control study in which 60 participants were recruited, 40 with the diagnosis of schizophrenia and bipolar affective disorders and 20 matched control ones selected from inpatient units and outpatient psychiatric clinics at the Institute of Psychiatry, Ain Shams University, over a period of 6 months. The recruited samples were assessed by a semistructured interview on the basis of the interview (questionnaire) sheet of the Institute of Psychiatry, Ain Shams University Hospital, and the diagnosis was made on the basis of the International Classification of Diseases-10 symptom checklist with an established diagnosis of acute psychosis. They were also assessed by the following measurements: blood pressure, body weight, circumference, laboratory investigations including assessment of fasting blood glucose level, using oral glucose tolerance test, lipid profile including assessment of triglyceride, cholesterol, and high-density lipoprotein level. RESULTS: The results for the clinical and laboratory profile of the three participant groups showed a highly significant correlation between fulfillment of the criteria of MetS and the pathology of psychotic and bipolar affective disorders. Moreover, the presence of positive risk factors for development of MetS was found to be significantly high among the two patient groups compared with the control one. CONCLUSION: Schizophrenic and bipolar drug-naive patients are more likely to develop metabolic changes; our results support the need for close monitoring of metabolic abnormalities and preferential use of metabolic neutral agents in this population as the first-line treatment option. Further research focusing on elucidation of the complicated relationship between metabolic disorders and psychiatric conditions may enable the development of earlier effective interventions. © 2014 Institute of Psychiatry, Ain Shams University.