Metabolic syndrome in antipsychotic naive African patients with severe mental illness in usual care

Early Interv Psychiatry. 2018 Dec;12(6):1137-1143. doi: 10.1111/eip.12428. Epub 2017 Apr 12.

Abstract

Background: To determine the prevalence and incidence of metabolic syndrome in individuals with a first episode of severe mental illness from South Africa.

Methods: Antipsychotic naïve study subjects with a first episode of severe mental illness and control subjects were recruited at baseline for a prospective study. Individuals without metabolic syndrome at baseline were followed up for 12 months after antipsychotic medication was initiated. Metabolic syndrome was determined at baseline and at the 12-month follow-up using the Joint Interim Statement criteria.

Results: At baseline, the 67 study (M:F; 48:19) and 67 control subjects (M:F; 48:19) had a mean age of 22.8 (±3.7) and 23.3 (±2.6) years (P = .4), respectively. The majority were of black African ethnicity (97%) and 82% were diagnosed with schizophrenia. There was no difference in the prevalence of metabolic syndrome (4.5%) or any of the individual components between the study and control group prior to the initiation of antipsychotics. Of the 64 study subjects without metabolic syndrome at baseline, only 36 (M:F; 25:11) completed the 12-month follow-up (response rate 56.3%) and 2 subjects developed metabolic syndrome .The incidence of metabolic syndrome was 5.5% with a significant increase in the elevated waist circumference criterion after 1 year of antipsychotic treatment (P = .02).

Conclusions: There was a low prevalence and incidence of metabolic syndrome in this group of patients with a first episode of severe mental illness.

Keywords: South Africa; antipsychotic agents; metabolic syndrome X.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / therapeutic use
  • Bipolar Disorder / epidemiology*
  • Case-Control Studies
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Male
  • Metabolic Syndrome / epidemiology*
  • Prevalence
  • Prospective Studies
  • Psychotic Disorders / epidemiology*
  • Schizophrenia / drug therapy
  • Schizophrenia / epidemiology*
  • South Africa / epidemiology
  • Waist Circumference
  • Young Adult

Substances

  • Antipsychotic Agents