The association between rehabilitation programs and metabolic syndrome in chronic inpatients with schizophrenia

Incidence and risk factors of depression in patients with metabolic syndrome

BACKGROUND

Many studies have explored the relationship between depression and metabolic syndrome (MetS), especially in older people. China has entered an aging society. However, there are still few studies on the elderly in Chinese communities.

AIM

To investigate the incidence and risk factors of depression in MetS patients in mainland China and to construct a predictive model.

METHODS

Data from four waves of the China Health and Retirement Longitudinal Study were selected, and middle-aged and elderly patients with MetS (n = 2533) were included based on the first wave. According to the center for epidemiological survey-depression scale (CESD), participants with MetS were divided into depression (n = 938) and non-depression groups (n = 1595), and factors related to depression were screened out. Subsequently, the 2-, 4-, and 7-year follow-up data were analyzed, and a prediction model for depression in MetS patients was constructed.

RESULTS

The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%. The prevalence of depression at the 2-, 4-, and 7-year follow-up was 29.55%, 34.53%, and 38.15%, respectively. The prediction model, constructed using baseline CESD and Physical Self-Maintenance Scale scores, average sleep duration, number of chronic diseases, age, and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up (area under the curve = 0.775, 95% confidence interval: 0.750-0.800, P < 0.001), with a sensitivity of 68% and a specificity of 74%.

CONCLUSION

The prevalence of depression in middle-aged and elderly patients with MetS has increased over time. The early identification of and intervention for depressive symptoms requires greater attention in MetS patients.

Prevalence of Metabolic Syndrome and Insulin Resistance in a Sample of Adult ADHD Outpatients

BACKGROUND

High prevalence of Metabolic Syndrome (MS) was found in patients with schizophrenia and bipolar disorders. Insulin Resistance (IR) seems to mediate MS role in developing cardiometabolic consequences.

AIMS

To investigate the prevalence of MS, and the role of MS components and IR surrogate indexes in determining MS in adult ADHD outpatients.

METHODS

In the present cross-sectional study, MS, defined according to the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III), and IR surrogate indexes were assessed on a consecutive sample of adult ADHD outpatients. Logistic regression analysis was performed to evaluate the effect of each ATP III component and IR surrogate index in determining MS.

RESULTS

Seventeen out of 158 patients (10.8%, 95%CI = 0.064/0.167) fulfilled the ATP-III criteria for MS. A comprehensive comparison with prevalence in the reference population was hindered by the lack of patients over 60 in the study sample, however under this age no significant differences were found. Among MS components, blood triglycerides level (OR = 1.02, 95%CI=1.01/1.03, p = 0.001) was the main predictor for MS, followed by diastolic blood pressure (OR = 1.08, 95%CI=1.01/1.16, p = 0.024) and waist circumference (OR = 1.06, 95%CI=1.01/1.13, p = 0.029). Lipid Accumulation Product (LAP, OR = 1.0006, 95%CI=1.0003/1.0009, p < 0.001) outperformed Triglyceride-Waist Circumference (TG-WC, OR=1.03, 95%CI=1.01/1.04, p < 0.001) in predicting MS.

CONCLUSIONS

More attention should be paid not only to MS but also to each ATP III component of MS and LAP in ADHD patients both at first assessment and during follow-up process.

Metabolic Syndrome and Dietary Habits in Hospitalized Patients with Schizophrenia: A Cross-Sectional Study

Background and Objectives: The true prevalence of metabolic syndrome (MetS) and the reason for it being higher in patients with schizophrenia when compared to general population have not yet been fully determined. Although being considered as one of the major causes, currently there are limited findings regarding differences in dietary patterns of schizophrenic patients with and without MetS. The present study aimed to determine the prevalence of MetS among hospitalized patients with schizophrenia, to investigate the differences in socio-demographic, clinical, and lifestyle characteristics between participants with and without MetS, with the special emphasis being put on their dietary habits, and to ascertain the correlation between dietary habits and MetS components. Materials and Methods: A cross-sectional study included 259 hospitalized patients with schizophrenia aged ≥ 18 years. All participants underwent basic anthropometric measurements, blood sampling and blood pressure assessment, and provided relevant socio-demographic and lifestyle information. The presence of MetS was determined according to the Joint Interim Statement definition and dietary habits were assessed using a non-quantitative food frequency questionnaire. Results: The overall prevalence of MetS was 47.9%. No socio-demographic or lifestyle differences were found between participants with and without MetS. A large number of participants (42.9%) reported consuming carbonated soft drinks on a daily basis. Daily frequency of fruit (11.6%) and vegetables intake (29.3%) was far below recommended. Dietary habits of participants with and without MetS did not significantly differ, while consumption frequencies of some of the studied food and beverage items and groups significantly correlated with certain MetS components (such as statistically significant positive correlation between cured meat products consumption frequency and waist circumference, as well as between red meat consumption frequency and systolic blood pressure). Conclusions: The concept of the present study did not allow us to distinguish to what extent the participants’ dietary habits were influenced by independent procurement of food products, nor has it allowed us to quantify the portion sizes of consumed food and beverage items and groups. Nevertheless, the findings indicate the need for early identification of individuals with high MetS risk and for the incorporation of nutritional support programs into hospital treatment of patients with schizophrenia.

Comparative Characteristics of the Metabolic Syndrome Prevalence in Patients With Schizophrenia in Three Western Siberia Psychiatric Hospitals

Objective: The purpose of this study was to compare the prevalence of MetS and the associated sociodemographic, clinical, and pharmacotherapeutic characteristics of patients with schizophrenia in three psychiatric hospitals in the West Siberian region. Methods: Patients with a clinical diagnosis of schizophrenia (ICD-10: F20) and an age between 18 and 60 years were included in the study after giving informed consent. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. This research was carried out at three Western Siberian psychiatric hospitals in Kemerovo, Tomsk, and Omsk. The study population included respectively 94, 131, and 91 inpatients with schizophrenia. We carried out schizophrenia symptoms assessment by PANSS, antipsychotic therapy evaluation, anthropometry, and biochemical analysis. Statistical Analysis included the Shapiro-Wilk test, non-parametric Kruskal-Wallis H-test for independent samples, Mann-Whitney U-test for independent samples, the chi-square test, stepwise multiple regression analyses. The level of significance was p < 0.05. Results: The metabolic syndrome prevalence was higher among patients in Tomsk (36.6%), compared with Kemerovo (20.2%, p = 0.008) or Omsk (18.7%, p = 0.004), mainly due to the high prevalence of abdominal obesity, while men from Tomsk were more susceptible to this condition than men from other regions (p < 0.05). Patients from Omsk had the highest severity schizophrenia symptoms according to PANSS, and patients from Tomsk had the lowest severity of positive symptoms according to PANSS. Patients from Tomsk had the minimum duration of antipsychotic therapy compared with the patient from Kemerovo (p = 0.017) and from Omsk (p = 0.000019), but most patients from Tomsk received second-generation atypical antipsychotics, while patients from Omsk received mainly conventional antipsychotics (p = 0.0001). Multiple regression analysis showed that metabolic syndrome associated with schizophrenia duration and body mass index, although the association was not so strong (adjusted R ² = 0.2435, p < 0.0001). Discussion: The study illustrates that in different psychiatric hospitals within the same region, the prevalence of metabolic syndrome in patients with schizophrenia can vary significantly, which dictates the need to look for opportunities to minimize the risk of its occurrence, taking into account the experience of each hospital.

Gender differences in metabolic syndrome risk factors among patients with serious mental illness

The prevalence of metabolic syndrome and its components continue to increase among patients with serious mental illness. This cross-sectional study investigated whether metabolic syndrome prevalence and risk factors differ between male and female patients with serious mental illness. In total, 260 eligible patients were recruited from two hospitals. The data on demographic characteristics, lifestyle behaviour factors, biochemistry, and anthropometry were collected. Analyses were performed using multivariate logistic regression. Metabolic syndrome prevalence was 40.8% (35.1% in men and 46.8% in women). Among patients aged 40-49 years, metabolic syndrome prevalence was higher in men; however, the trend was reversed among patients aged 50 years or older. Notably, gender-specific metabolic syndrome risk factors were observed. In men, they included low education level, high body mass index (BMI), prolonged illness, comorbid physical illness, and diagnosis of bipolar disorder, whereas they included being married, old age, and high BMI in women. Our findings suggest that mental health professionals should consider the gender- and age-based metabolic syndrome prevalence trend in patients with serious mental illness when designing interventions for the study population to minimize metabolic syndrome prevalence.