title: Metabolic syndrome in antipsychotic naive African patients with severe mental illness in usual care.
abstract: To determine the prevalence and incidence of metabolic syndrome in individuals with a first episode of severe mental illness from South Africa.
  
  
  
  Antipsychotic naïve study subjects with a first episode of severe mental illness and control subjects were recruited at baseline for a prospective study. Individuals without metabolic syndrome at baseline were followed up for 12 months after antipsychotic medication was initiated. Metabolic syndrome was determined at baseline and at the 12-month follow-up using the Joint Interim Statement criteria.
  
  
  
  At baseline, the 67 study (M:F; 48:19) and 67 control subjects (M:F; 48:19) had a mean age of 22.8 (±3.7) and 23.3 (±2.6) years (P = .4), respectively. The majority were of black African ethnicity (97%) and 82% were diagnosed with schizophrenia. There was no difference in the prevalence of metabolic syndrome (4.5%) or any of the individual components between the study and control group prior to the initiation of antipsychotics. Of the 64 study subjects without metabolic syndrome at baseline, only 36 (M:F; 25:11) completed the 12-month follow-up (response rate 56.3%) and 2 subjects developed metabolic syndrome .The incidence of metabolic syndrome was 5.5% with a significant increase in the elevated waist circumference criterion after 1 year of antipsychotic treatment (P = .02).
  
  
  
  There was a low prevalence and incidence of metabolic syndrome in this group of patients with a first episode of severe mental illness.
authors.affiliation: Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Shamima
authors.initials: S
authors.lastname: Saloojee
authors.affiliation: Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Burns
authors.affiliation: Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Ayesha A
authors.initials: AA
authors.lastname: Motala
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000453:epidemiology*; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: South Africa; antipsychotic agents; metabolic syndrome X