title: The prevalence of metabolic syndrome in people with severe mental illness: a mediation analysis.
abstract: BACKGROUND
  People with severe mental illness (SMI) generally have high rates of metabolic syndrome (MetS). Proposed explanations remain conjectural. Relatively little is known about Mets in SMI in Southern Europe, an area with generally healthy dietary traditions.
  
  
  OBJECTIVE
  To establish prevalence rates of MetS in an Italian sample, and testing hypotheses about putative reasons for the excess in the SMI group.
  
  
  METHODS
  We compared the prevalence and correlates of MetS in inpatients with SMI and controls randomly chosen from patients undergoing routine maxillofacial surgery. We employed formal tests of mediation.
  
  
  RESULTS
  The MetS prevalence rate was 26.1 % in the SMI group and 15.9 % in the comparison group. After controlling for age, people with SMI were three times more likely to have MetS than their non-SMI counterparts. Smoking and a family history of cardiovascular disease were strongly related to MetS in both groups. However, these factors could not explain the excess of MetS in the SMI group, and we found no effect of antipsychotic dose.
  
  
  CONCLUSIONS
  SMI remained prominent in increasing the likelihood of MetS in this low prevalence population, and putative determinants of MetS were common to people with SMI and to controls. Explanations for high MetS rates in SMI may lie in health behaviours other than smoking.
authors.affiliation: Mental Health Sciences Unit, Faculty of Brain Sciences, University College London, London, UK.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carrà
authors.forename: Francesco
authors.initials: F
authors.lastname: Bartoli
authors.forename: Daniele
authors.initials: D
authors.lastname: Carretta
authors.forename: Cristina
authors.initials: C
authors.lastname: Crocamo
authors.forename: Alberto
authors.initials: A
authors.lastname: Bozzetti
authors.forename: Massimo
authors.initials: M
authors.lastname: Clerici
authors.forename: Paul E
authors.initials: PE
authors.lastname: Bebbington
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology*; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*
chemical_list: D014150:Antipsychotic Agents