Deterioration of metabolic parameters during short-term psychiatric inpatient treatment: A prospective naturalistic study

Abstract

Objective. To investigate the influence of a single episode of psychiatric inpatient treatment on metabolic parameters. Methods. A total of 294 consecutive patients of an Upper Austrian psychiatric department were assessed at admission and discharge regarding bodyweight, body mass index (BMI), high density cholesterol (HDL), low density cholesterol (LDL), triglycerides (TG) and fasting glucose (FG), and the TG/HDL ratio. Results. Patients showed an increase of BMI of 0.35 kg/m² (+ 1.3%) during a mean duration of inpatient stay of 25.8 days. LDL rose by 10.7 mg/dl (+ 8.1%), triglycerides by 23.0 mg/dl (+ 17%), HDL decreased by 4.4 mg/dl (−7.4%). Fasting glucose decreased by 3.6 mg/dl (−3.8%), yet the TG/HDL ratio, as a marker for insulin resistance, increased significantly from 2.86 to 3.58 (+ 25.2%) on average. Patients with psychotic disorders gained about three times more weight than patients with other diagnoses. Negative alterations of serum lipids were to be found in all diagnostic groups but were especially pronounced in patients with psychotic disorders who were treated with second-generation antipsychotics clozapine, olanzapine and quetiapine. Conclusions. Psychiatric inpatient treatment leads to clinically relevant deterioration of metabolic parameters within a short time, most pronouncedly in patients with psychotic disorders.

Key Words::

• Psychiatric inpatient
• serum glucose
• serum lipids
• weight gain
• metabolic parameters

Acknowledgements

Many thanks to Robert Frühwirth, Hildegard Lindner, Rosa Mayr and Vera Pihurik, who were helpful in data collection.

Statement of Interest

This work was supported in part by an unrestricted grant by Eli Lilly Austria. Hans Rittmannsberger has received honoraria from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Merz, Schering-Plough, Sanofi-Synthelabo. Thomas Zaunmüller has received honoraria from Merz. The other authors report no declaration of interest.