Characterization of metabolic syndrome among forensic psychiatric inpatients

Schizophrenia and other psychotic disorders seem to be linked with metabolic syndrome. Metabolic syndrome is an important preceding factor for Type 2 diabetes mellitus and cardiovascular diseases. The objective of this study was to investigate the prevalence of metabolic syndrome and its risk determinants among psychotic forensic psychiatric inpatients with comorbidities of antisocial personality or alcohol dependence. The study sample consisted of 221 forensic psychiatric inpatients in Finland, with a median age of 41 years, of which 92% had a diagnosis of schizophrenia or a related psychosis. The patients had been on constant second-generation antipsychotic medication for over six months. The use of clozapine (OR 8.1), quetiapine (OR 7.7), and olanzapine (OR 3.6) was associated with the occurrence of metabolic syndrome. The beneficial high density lipoprotein cholesterol profile was correlated with the use of selective serotonin uptake inhibitor (SSRI), and with a diagnosis of alcohol dependence, even after alcohol abstinence. Metabolic syndrome was associated especially with the use of clozapine and quetiapine. Our novel finding was that SSRI use and previous diagnosis of alcohol dependence may have a lowering effect on the prevalence of metabolic syndrome.

Keywords:

• metabolic syndrome
• schizophrenia
• forensic psychiatry
• HDL cholesterol
• serotonin uptake inhibitors
• alcoholism

Acknowledgements

The study was supported by Annual EVO Financing (special government subsidies) from Niuvanniemi Hospital, Kuopio, Finland.