Weight gain, dyslipidemia and altered parameters for metabolic syndrome on first episode psychotic patients after six-month follow-up.
OBJECTIVE
Obesity and metabolic abnormalities are frequent in psychotic patients, including first-episode psychosis. We evaluated weight and metabolic parameters in first-episode psychotic outpatients from the First Episode Psychosis Program, Universidade Federal de São Paulo.


METHODS
Weight, height, waist and hip circumferences, glucose and lipid levels were measured at baseline and after a six-month period.


RESULTS
Fifty-seven patients were included and 44 (77.2%) of them finished the study. Patients had a median age of 26.3 years, 60% were men and 43% had a diagnosis of schizophrenia at the endpoint. Weight and BMI values increased significantly during the follow-up (p < 0.01). The average weight gain at the follow-up was 10.1% of the baseline weight (SD = 11.9). Only women presented significant waist abnormalities: at the first assessment the waist mean was 79.12 cm (SD = 10.68) and 6 months later it had increased to 89.65 cm (SD = 11.19, z = -3.182, p = 0.001). After 6 months, the total cholesterol (p = 0.004), and triglyceride levels (p = 0.016) increased, while HDL-cholesterol levels decreased (p = 0.025). During the follow-up period one patient (2.3%) developed diabetes mellitus, one (2.3%) presented altered fasting glucose, 12 (27.2%) patients developed at least two altered parameters for metabolic syndrome and 3 (6.8%) patients developed metabolic syndrome (p = 0.001).


CONCLUSIONS
The results of this study showed that in a short period of time individuals under antipsychotic treatment had their weight increased significantly and developed important metabolic abnormalities.


CONCLUSIONS
Clinicians should be aware of these risks, choose an antipsychotic that causes less weight gain and should monitor these patients carefully, and recommend prophylactic measures as diet restriction and physical activities.
Attux
Cecília
C
First-episode Psychosis Program, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil. cattux@gmail.com
Quintana
Maria Inês
MI
Chaves
Ana Cristina
AC
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D015992:Body Mass Index; D001835:Body Weight; D001938:Brazil / Q000453:epidemiology; D050171:Dyslipidemias / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D009765:Obesity / Q000139:chemically induced*; D011618:Psychotic Disorders / Q000188:drug therapy*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D015430:Weight Gain / Q000187:drug effects*
D014150:Antipsychotic Agents