Metabolic syndrome and psychiatrists' choice of follow-up interventions in patients treated with atypical antipsychotics in Denmark and Sweden.
BACKGROUND
The aim of the present study was to obtain point prevalence estimates of the metabolic syndrome according to the NCEP III criteria in a sample of patients with schizophrenia spectrum disorders treated with atypical antipsychotic drugs in Denmark and Sweden, and to assess the psychiatrists' choice of recommendations for follow-up interventions based on the patients' laboratory results.


METHODS
This was a cross-sectional, observational multi-center study in Denmark and Sweden, in consecutively screened in- and outpatients with schizophrenia spectrum disorders and continuously treated for at least 3 months with atypical antipsychotic drugs.


RESULTS
The metabolic syndrome as per medical history was present in 1% of 582 evaluable patients at baseline. After performing laboratory measurements and applying the NCEP III criteria, metabolic syndrome was confirmed in 43% of subjects. The high rate of metabolic syndrome did not elicit much decisive action on the part of the treating psychiatrists; the most frequent action taken was dietary and exercise advice (in 75% of subjects), while in 54% and 19% of subjects a laboratory follow-up and blood pressure follow-up were advised respectively. Change of antipsychotic medication was recommended in only 10% of patients, and in further 11% of patients, no action was taken.


CONCLUSIONS
Observed metabolic syndrome prevalence rates were at least twice the rates observed in a normal, non-diabetic population. It appears that in this vulnerable population of patients with schizophrenia spectrum disorders, metabolic syndrome remains underdiagnosed and undertreated.
Larsen
John Teilmann
JT
Department of Psychiatry, Odense University Hospital, 5000 Odense C, Denmark. teilmann@dadlnet.dk
Fagerquist
Maria
M
Holdrup
Mette
M
Christensen
Bjarne
B
Sigalin
Catarina
C
Nilsson
Peter M
PM
D000328:Adult; D000553:Ambulatory Care / Q000592:standards*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D008660:Metabolism / Q000187:drug effects*; D008875:Middle Aged; D008991:Monitoring, Physiologic; D020380:Needs Assessment; D015995:Prevalence; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
D014150:Antipsychotic Agents