Abstract
Background. An increased risk for metabolic syndrome has been described for persons with psychotic and mood disorders. Our objectives were to determine whether the odds for metabolic syndrome (MetSyn) were increased among insured adults with and without mental illness, and to determine whether this risk extends beyond psychotic and affective disorders.
Method. This was a retrospective analysis of a 100% sample of Blue Cross/Blue Shield of Iowa claims data. Three definitions of MetSyn were examined: 1) presence of any 3 or more components of MetSyn (obesity, hypertriglyceridemia, hypercholesterolemia, hypertension, and glucose intolerance/diabetes mellitus), 2) criteria #1 and/or claim for glucose intolerance/diabetes mellitus, and 3) criteria #1, criteria #2, and/or claim for obesity. ICD-9 codes were used to define obesity, hypertriglyceridemia, hypercholesterolemia, hypertension, and glucose intolerance/diabetes mellitus. Multivariate logistic regression was used to investigate the association between mental illness and MetSyn.
Results. Prevalence of MetSyn for subjects with any mental illness as compared to those without was 4.9% vs. 2.0% (criteria #1), 8.1% vs. 4.2% (criteria #2), and 13.2% vs. 6.2% (criteria #3). MetSyn was more common (OR = 1.3–1.5) for subjects with any mental illness as compared to those without, regardless of which definition of MetSyn was used. Subjects with sexual disorders (OR = 1.7–1.8), sleep disorders (OR = 1.2–1.7), and mood disorders (OR = 1.3–1.6) had significantly higher odds of MetSyn compared to those without claims for mental disorders, regardless of which definition of MetSyn was used.
Conclusions. These results suggest that MetSyn is not only problematic among persons with psychosis and affective disorders, but that it also affects patients with other forms of mental illness. Clinicians should have a heightened awareness of metabolic risk factors, particularly when mental illness is present.
Notes
aNumber of non-mental healthcare visits during the entire study period.
bCalculated from first medical visit to last medical visit during study period, 1996–2001.
aAt least 3 of the 5 ATP III criteria (obesity, hypertriglyceridemia, hypercholesterolemia, hypertension, diabetes mellitus/glucose intolerance).
bCriteria 1 and/or claim for diabetes mellitus/glucose intolerance.
cCriteria 1, Criteria 2, and/or claim for obesity.
dNumber of non-mental healthcare visits during the entire study period.
eCalculated from first medical visit to last medical visit during study period, 1996–2001.
aAdjusted for age, gender, and number of non-mental healthcare visits during the study period.
bAt least 3 of the 5 ATP III criteria (obesity, hypertriglyceridemia, hypercholesterolemia, hypertension, diabetes mellitus/glucose intolerance).
cCriteria 1 and/or claim for diabetes mellitus/glucose intolerance.
dCriteria 1, Criteria 2, and/or claim for obesity.