Prevalence and predictors of metabolic syndrome among psychiatric patients receiving antipsychotic treatment in Africa: a systematic review and meta-analysis.

BACKGROUND

Antipsychotic medications, though essential for treating severe mental illnesses, are commonly associated with metabolic side effects that increase the risk of metabolic syndrome (MetS). These metabolic complications significantly undermine treatment adherence and contribute to adverse clinical outcomes. Despite the increasing utilization of antipsychotics in Africa, there remains a critical lack of region-specific data on the prevalence and determinants of metabolic syndrome in this population. This systematic review and meta-analysis aims to synthesize existing data on the prevalence and predictors of MetS among psychiatric patients receiving antipsychotic treatment in Africa.

METHOD

We looked for primary papers on PubMed/MEDLINE, Scopus, African Journal Online, PsycINFO, EMBASE, Psychiatry Online, CINAHL, Science Direct, and the Cochrane Library. We included original research articles that evaluated the prevalence of metabolic syndrome among psychiatric patients treated with antipsychotic medication. Two independent reviewers examined the articles and extracted data. The I² statistic was employed to assess statistical heterogeneity, and a random-effects meta-analysis was applied due to the observed heterogeneity. Publication bias was evaluated using a funnel plot and Egger's weighted regression test. This review has been registered with PROSPERO (ID = CRD42024558310).

RESULTS

This systematic review analyzed 25 primary studies encompassing a total of 4,064 participants. The pooled prevalence of metabolic syndrome among psychiatric patients receiving antipsychotic treatment in Africa was estimated at 22% (95% CI: 16.33-27.66). Female gender (OR = 3.28, 95% CI: 1.73-6.23), advanced age (OR = 1.07, 95% CI: 1.03-1.12), and elevated body mass index (OR = 5.33, 95% CI: 2.35-12.12) were identified as significant risk factors for metabolic syndrome in this population.

CONCLUSION

Metabolic syndrome is highly prevalent among psychiatric patients receiving antipsychotic treatment in Africa, with female sex, older age, and elevated body mass index identified as significant risk factors. These findings underscore the need for routine metabolic monitoring and timely interventions to mitigate cardiovascular risk, enhance treatment adherence, and prevent recurrence of psychiatric symptoms.