The prevalence of metabolic syndrome amongst patients with severe mental illness in the community in Hong Kong--a cross sectional study

Daniel T Bressington, Jolene Mui, Eric F C Cheung, Joel Petch, Allan B Clark, Richard Gray, Daniel T Bressington, Jolene Mui, Eric F C Cheung, Joel Petch, Allan B Clark, Richard Gray

Abstract

Background: Patients with severe mental illness are at increased risk of developing metabolic disorders. The risk of metabolic syndrome in the Hong Kong general population is lower than that observed in western countries; however the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong is unknown.

Method: This cross-sectional study aimed to estimate the prevalence of metabolic syndrome in patients with severe mental illness in Hong Kong and to identify the relationships between metabolic syndrome and socio-demographic, clinical and lifestyle factors.

Results: A total of 139 patients with a diagnosis of severe mental illness participated in the study. The unadjusted prevalence of metabolic syndrome was 35%. The relative risk of metabolic syndrome in comparison with the general Hong Kong population was 2.008 (95% CI 1.59-2.53, p < 0.001). In a logistic regression model sleep disruption and being prescribed first generation antipsychotics were significantly associated with the syndrome, whilst eating less than 3 portions of fruit/vegetables per day and being married were weakly associated.

Conclusion: The results demonstrate that metabolic syndrome is highly prevalent and that physical health inequalities in patients with severe mental illness in Hong Kong are similar to those observed in western countries. The results provide sufficient evidence to support the need for intervention studies in this setting and reinforce the requirement to conduct regular physical health checks for all patients with severe mental illness.

References

    1. Colton CW, Manderscheid RW. Congruencies in increased mortality rates,years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis. 2006;3:1–14.
    1. Law, Yip. Healthy life expectancy in Hong Kong special administrative region of China. Bull World Health Organ. 2003;81:43–47.
    1. Brown S, Inskipp H, Baroclough B. Causes of excess mortality of schizophrenia. Br J Psychiatry. 2000;177:212–217. doi: 10.1192/bjp.177.3.212.
    1. Eldridge D, Dawber N, Gray R. A well-being support program for patients with severe mental illness: a service evaluation. BMC Psychiatry. 2011;11:46. doi: 10.1186/1471-244X-11-46.
    1. McEvoy P, Meyer J, Goff D, Nasrallah H, Davis S, Sullivan L, Meltzer H, Hsiao J, Stroup S, Lieberman J. Prevalence of the metabolic syndrome in patients with schizophrenia: baseline results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial and comparison with national estimates from NHANES III. Schizophr Res. 2005;80:19–32. doi: 10.1016/j.schres.2005.07.014.
    1. Ko G, Tang J. Metabolic syndrome in the Hong Kong community: the United Christian Nethersole Community Health Service primary healthcare programme 2001–2002. Singapore Med J. 2007;48(12):1111–1116.
    1. Ko G, Cockram C, Chow C, Yeung V, Chan W, So W, Chan N, Chan J. Metabolic syndrome by the international diabetes federation definition in Hong Kong Chinese. Diabetes Res Clin Pract. 2006;73:58–64. doi: 10.1016/j.diabres.2005.11.009.
    1. Thomas GN, Schooling CM, McGhee SM, Ho DSY, Cheung BMY, Wat NMS, Janus ED, Lam KSL, Lam TH. Metabolic syndrome increases all-cause and vascular mortality: the Hong Kong cardiovascular risk factor study. Clin Endocrinol. 2007;66(5):666–671. doi: 10.1111/j.1365-2265.2007.02798.x.
    1. White J, Gray R, Jones M. The development of the serious mental illness physical Health Improvement Profile. J Psychiatr Ment Heal Nurs. 2009;16:493–498. doi: 10.1111/j.1365-2850.2009.01375.x.
    1. White J. The serious mental illness health improvement profile [HIP]: study protocol for a cluster randomised controlled trial. Trials. 2011;12:167. doi: 10.1186/1745-6215-12-167.
    1. Shuel F, White J, Jones M, Gray R. Using the serious mental illness health improvement profile [HIP] to identify physical problems in a cohort of community patients: a pragmatic case series evaluation. Int J Nurs Stud. 2010;47(2):136–145. doi: 10.1016/j.ijnurstu.2009.06.003.
    1. International Diabetes Federation consensus workshop. The IDF consensus worldwide definition of the METABOLIC SYNDROME. International Diabetes Federation; 2006. available at: [ ]
    1. Straker DA, Rubens E, Koshy F, Kramer E, Manu P. The prevalence of the metabolic syndrome among patients treated with atypical antipsychotic. San Francisco: Abstract Presented at the American Psychiatric Association Annual Meeting; 2003.
    1. Kato MM, Currier MB, Gómez CM, Hall L, González-Blanco M. Prevalence of metabolic syndrome in Hispanic and non-Hispanic patients with schizophrenia. Prim. Care Companion; J Clin Psychiatry. 2004;6:74–77. doi: 10.4088/PCC.v06n0205.
    1. John A, Koloth R, Dragovic M, Lim S. Prevalence of metabolic syndrome among Australians with severe mental illness. Med J Aust. 2009;190(4):176–179.
    1. Cohn T, Prud’homme D, Streiner D, Kameh H, Remington G. Characterizing coronary heart disease risk in chronic schizophrenia: high prevalence of the metabolic syndrome. Can J Psychiatry. 2004;49:753–760.
    1. Heiskanen T, Niskanen L, Lyytikainen R, Saarinen PI, Hintikka J. Metabolic syndrome in patients with schizophrenia. J Clin Psychiatry. 2003;64:575–579. doi: 10.4088/JCP.v64n0513.
    1. Littrell KH, Petty R, Ortega TR, Moore D, Ballard A, Clough R, Lan T-S, Selby C. Insulin resistance and syndrome X among patients with schizophrenia. San Francisco: Abstract Presented at the American Psychiatric Association Annual Meeting; 2003.
    1. Srisurapanont M, Likhitsathian S, Boonyanaruthee V. Metabolic syndrome in Thai schizophrenic patients: a naturalistic one year follow-up study. BMC Psychiatry. 2007;23:7–14.
    1. De Hert M, van Winkel R, Van Eyck D, Hanssens L, Wampers M, Scheen A, Peuskens J. Prevalence of diabetes, metabolic syndrome and metabolic abnormalities in schizophrenia over the course of the illness: a cross-sectional study. Clin Prac Epidemiol Ment Health. 2006;2:14. doi: 10.1186/1745-0179-2-14.
    1. Troxel WM, Matthews KA, Gallo LC, Kuller LH. Marital quality and occurrence of the metabolic syndrome in women. Arch Int Med. 2005;165:1022–1027. doi: 10.1001/archinte.165.9.1022.
    1. Lin CC, Liu CS, Lai MM, Li CI, Chen CC, Chang PC, Lin WY, Lee YD, Li TC. Metabolic syndrome in a Taiwanese metropolitan adult population. BMC Publ Health. 2007;7:239. doi: 10.1186/1471-2458-7-239.
    1. Robson D, Gray R. Serious mental illness and physical health problems: a discussion paper. Int J Nurs Stud. 2007;44:457–466. doi: 10.1016/j.ijnurstu.2006.07.013.
    1. Hennekens CH, Hennekens AR, Hollar D. Schizophrenia and increased risks of cardiovascular disease. Am Heart J. 2005;150:1115–1121. doi: 10.1016/j.ahj.2005.02.007.
    1. Hall MH, Muldoon MF, Jennings JR, Buysse DJ, Flory JD, Manuck SB. Self-reported sleep duration is associated with the metabolic syndrome in midlife adults. Sleep. 2008;31(5):635–643.
    1. Lam JC, Ip M. Sleep & the metabolic syndrome. Indian J Med Res. 2010;131:206–216.
    1. Tschoner A, Engl J, Laimer M, Kaser S, Rettenbacher M, Fleischhacker W, Patsch J, Ebenbichler C. Metabolic side effects of antipsychotic medication. Int J Clin Pract. 2007;61(8):1356–1370. doi: 10.1111/j.1742-1241.2007.01416.x.
    1. Suvisaari JM, Saarni SI, Perälä J. Metabolic syndrome among persons with schizophrenia and other psychotic disorders in a general population survey. J Clin Psychiatry. 2007;68:1045–1055. doi: 10.4088/JCP.v68n0711.

Source: PubMed

3
Subskrybuj