Kar Nilamadhab, Barreto Socorro
University of Wolverhampton, United Kingdom.
Dept. of Psychiatry, Black Country Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom.
Indian J Psychol Med. 2024 Jul;46(4):313-322. doi: 10.1177/02537176231219770. Epub 2024 Jan 31.
Metabolic syndrome (MetS) is a concern in psychiatric patients. We aimed to study the influence of the modifiable lifestyle factors on MetS in adult psychiatric patients along with associated clinical factors and quality of life.
Factors such as diet (Healthy Eating Index), exercise, substance use, cardiovascular risk (QRISK), illness severity (Clinical Global Impression), medications, adverse events (Systematic Monitoring of Adverse Events Related to Treatments), and quality of life (Recovering Quality of Life Scale) were assessed along with clinical components for MetS in 323 psychiatric patients receiving routine care and monitoring in a Community Mental Health Team.
MetS was present in 50.5% (95% CI: 45.0-55.9). It was significantly associated with higher age, duration of mental illness, body mass index (BMI), QTc, QRISK, and antipsychotic drugs. In logistic regression, age, QTc, QRISK, and BMI remained significantly linked to MetS. Patients with or without MetS were comparable in their lifestyle factors such as diet, exercise, and substance use, along with the family history of metabolic disorders, age at onset of mental illness, duration of antipsychotic medication, side effects, psychiatric diagnoses, and quality of life. However, many patients with or without MetS had poorer diet and physical inactivity, indicating scope for interventions.
Around half of the psychiatric patients had MetS, and modifiable lifestyle factors did not differentiate individuals with or without MetS. The need for further research on the prevention and management of MetS in psychiatric patients is highlighted.
代谢综合征(MetS)是精神科患者中值得关注的问题。我们旨在研究可改变的生活方式因素对成年精神科患者代谢综合征的影响,以及相关的临床因素和生活质量。
对323名在社区精神卫生团队接受常规护理和监测的精神科患者,评估了饮食(健康饮食指数)、运动、物质使用、心血管风险(QRISK)、疾病严重程度(临床总体印象)、药物治疗、不良事件(与治疗相关不良事件的系统监测)和生活质量(生活质量恢复量表)等因素,以及代谢综合征的临床组成部分。
50.5%(95%可信区间:45.0 - 55.9)的患者存在代谢综合征。它与较高的年龄、精神疾病病程、体重指数(BMI)、QTc、QRISK以及抗精神病药物显著相关。在逻辑回归分析中,年龄、QTc、QRISK和BMI仍然与代谢综合征显著相关。有或无代谢综合征的患者在饮食、运动和物质使用等生活方式因素方面,以及代谢紊乱家族史、精神疾病发病年龄、抗精神病药物治疗时长、副作用、精神科诊断和生活质量方面具有可比性。然而,许多有或无代谢综合征的患者饮食较差且缺乏身体活动,这表明有进行干预的空间。
约一半的精神科患者患有代谢综合征,可改变的生活方式因素并不能区分有或无代谢综合征的个体。这凸显了对精神科患者代谢综合征预防和管理进行进一步研究的必要性。