DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20205690

Metabolic syndrome in psychiatric outpatients in a tertiary care center in Eastern India

Kaustav Chakraborty, Moumita Chatterjee, Ranjan Bhattacharyya, Amitava Dan, Rajarshi Neogi

Abstract


Background: Metabolic syndrome (MS) refers to a clustering of metabolic risk factors and compared to the general population, the prevalence of MS and its components is higher in populations with mental illness across all major diagnostic groups. Aim was to study the prevalence and correlates of MS in a cohort of psychiatric outpatients in a tertiary care centre in Eastern India.

Methods: One hundred and sixty-four consecutive patients attending the outpatient service of Department of Psychiatry were recruited. The sociodemographic, clinical and physical activity profile of these patients were recorded by using a proforma specially designed for this purpose. Metabolic syndrome (MS) was diagnosed by the International Diabetic Federation criteria (IDF, 2006).

Results: A typical subject was: married (64.6%), male (63.4%) and aged 38.76 years. The most common ICD-10 diagnostic categories were unipolar depression (28%), neurotic, stress related and somatoform disorders (28%), psychoses (21.9%), and bipolar disorder (9.7%). The mean age for onset and duration of illness were 31.65 years and 79 months respectively. The mean number and duration of psychotropic medication received by the subjects were 2.51 and 25.9 months respectively. An IDF criteria-based diagnosis of MS was made in 39% cases. A diagnosis of MS had a significant positive correlation with age, age at onset, duration since onset, number of comorbid medical illness, duration and number of psychotropic medications received, depressive disorders, and BMI.

Conclusions: MS is common among subjects with psychiatric disorders and the prevalence of MS in our sample was consistent with the findings reported in literature.


Keywords


Correlates, Metabolic syndrome, Prevalence, Psychiatric disorders

Full Text:

PDF

References


Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatr. 2014;13(2):153-60.

Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365:1415-28.

Reaven GM. Role of insulin resistance in human disease (syndrome X): an expanded definition. Ann Rev Med. 1993;44:121-31.

Chambers JC, Eda S, Bassett P, Karim Y, Thompson SG, Gallimore JR. et al. C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites. Circulation. 2001;104:145-50.

Ford ES, Giles WH, Dietz WH. Prevalence of metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA. 2002;287:356-9.

Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults: Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (executive summary). Circulation. 2005;112:2735-52.

Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome- a new worldwide definition. A Consensus Statement from the International Diabetes Federation. Diabetes Med. 2005;23:469-80.

Cameron AJ, Shaw JE, Zimmet PZ. The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin N Am. 2004;33:351-3.

Gupta A, Gupta R, Sarna M, Rastogi S, Gupta VP, Kothari K. Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Res Clin Pract. 2003;61:69-76.

Deepa M, Farooq S, Datta M, Deepa R, Mohan V. Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai urban rural epidemiology study (CURES-34). Diabetes Metab Res Rev. 2007;23:127-34.

Rawat VS, Ganesh S, Bijjal S, Shanivaram Reddy K, Agarwal V, Devi R, et al. Prevalence and predictors of metabolic syndrome in patients with schizophrenia and healthy controls: A study in rural South Indian population. Schizophr Res. 2018;192:102-7.

Vancampfort D, Stubbs B, Mitchell AJ, De Hert M, Wampers M, Ward PB, et al. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis. World Psychiatr. 2015;14(3):339-47.

Vancampfort D, Wampers M, Mitchell AJ, Correll CU, De Herdt A, Probst M, et al. A meta-analysis of cardio-metabolic abnormalities in drug naïve, first-episode and multiepisode patients with schizophrenia versus general population controls. World Psychiatr. 2013;12(3):240-50.

Carney R, Cotter J, Bradshaw T, Firth J, Yung AR. Cardiometabolic risk factors in young people at ultra-high risk for psychosis: a systematic review and meta-analysis. Schizophr Res. 2016;170(2-3):290-300.

Emul M, Kalelioglu T. Etiology of cardiovascular disease in patient with schizophrenia: Current perspectives. Neuropsychiatr Dis Treat. 2015;11:2493-503.

Pan A, Keum N, Okereke OI, Sun Q, Kivimaki M, Rubin RR, et al. Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care. 2012;35(5):1171-80.

Vancampfort D, Vansteelandt K, Correll CU, Mitchell AJ, De Herdt A, Sienaert P, et al. Metabolic syndrome and metabolic abnormalities in bipolar disorder: a meta-analysis of prevalence rates and moderators. Am J Psychiatr. 2013;170(3):265-74.

Tang F, Wang G, Lian Y. Association between anxiety and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Psychoneuroendocrinology. 2017;77:112-21.

Mattoo SK, Singh SM. Prevalence of metabolic syndrome in psychiatric inpatients in a tertiary care centre in north India. Indian J Med Res. 2010;131:46-52.

Gautam S, Meena PS. Drug-emergent metabolic syndrome in patients with schizophrenia receiving atypical (second-generation) antipsychotics. Indian J Psychiatr. 2011;53:128-33.

Grover S, Aggarwal M, Dutt A, Chakrabarti S, Avasthi A, Kulhara P, et al. Prevalence of metabolic syndrome in patients with schizophrenia in India. Psychiatr Res. 2012;200(2-3):1035-7.

Grover S, Aggarwal M, Chakrabarti S, Dutt A, Avasthi A, Kulhara P, et al. Prevalence of metabolic syndrome in bipolar disorder: an exploratory study from North India. Prog Neuropsychopharmacol Biol Psychiatr. 2012;36(1):141-6.

Grover S, Nebhinani N, Chakrabarti S, Avasthi A, Basu D, Kulhara P, et al. Cardiac risk factors and metabolic syndrome in patients with schizophrenia admitted to a general hospital psychiatric unit. Indian J Psychiatr. 2014;56(4):371-6.

Grover S, Nebhinani N, Chakrabarti S, Avasthi A, Kulhara P, Basu D, et al. Comparative study of prevalence of metabolic syndrome in bipolar disorder and schizophrenia from North India. Nord J Psychiatr. 2014;68(1):72-7.

Agarwal A, Agarwal M, Garg K, Dalal PK, Trivedi JK, Srivastava JS. Metabolic syndrome and central obesity in depression: A cross-sectional study. Indian J Psychiatr. 2016;58:281-6.

Malhotra N, Kulhara P, Chakrabarti S, Grover S. Lifestyle related factors and impact of metabolic syndrome on quality of life, level of functioning and self-esteem in patients with bipolar disorder and schizophrenia. Indian J Med Res. 2016;143(4):434-42.

Das D, Bora K, Baruah B, Konwar G. Prevalence and predictors of metabolic syndrome in schizophrenia patients from Assam. Indian J Psychiatr. 2017;59:228-32.

Hussain T, Margoob MA, Shoib S, Shafat M, Chandel RK. Prevalence of Metabolic Syndrome among Psychiatric Inpatients: A Hospital Based Study from Kashmir. J Clin Diagn Res. 2017;11(6):5-8.

World Health Organization. International Classification of Diseases, 10th Revision (ICD-10). Geneva, Switzerland: World Health Organization; 1992. Available from: https://www.who.int/ classifications/icd/ICD10Volume2_en_2010.pdf.

Naing L, Winn T, Rusli BN. Sample size calculator for prevalence studies, version 1.0.01. Available at: http://www.kck.usm.my/ppsg//stats_resource.htm.

IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

McEvoy JP, Mayer JM, Goff DC, Nasrallah HA, Davis SM, Sullivan L, et al. Prevalence of 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. Schizophrenia Res. 2005;80:19-32.

Kindler LS, Carnethon MR, Palaniappan LP, King AC, Fortmann SP. Depression and the metabolic syndrome in young adults: findings from the national health and nutrition examination survey. Psychosom Med. 2004;66:316-32.