Research Article
BibTex RIS Cite

Metabolic Syndrome and Related Factors in Patients with Schizophrenia

Year 2025, Volume: 52 Issue: 3, 577 - 587, 16.09.2025
https://doi.org/10.5798/dicletip.1785148

Abstract

Aim: To assess the prevalence rate of metabolic syndrome (MetS) in patients with schizophrenia and to determine related socio-demographic features and clinical characteristics.
Methods: Fifty-five inpatients diagnosed with schizophrenia were included. A demographic and clinical data form was completed. The laboratory results were retrieved from the hospital information system. Patients' weight, height, waist circumference, and blood pressure were measured. The diagnosis of MetS was made based on the NCEP ATP III (Adult Treatment Protocol of the National Cholesterol Education Program), ATP III-A (Adapted) and IDF (International Diabetes Federation) criteria.
Results: The prevalence rate of MetS was 38.2% according to the IDF and 25.5% based on ATP III and ATP III-A criteria. The mean age, duration of illness, length of medication use, and time between symptom onset and diagnosis were significantly higher in patients with schizophrenia with MetS (p<0.05). The groups differed significantly in height, weight, and body mass index (BMI) (p<0.05). Regarding the MetS criteria, there was a significant difference between groups in waist circumference, fasting triglycerides, and fasting HDL levels (p<0.05). Patients with MetS were more frequently treated with depot antipsychotics (p<0.05).
Conclusion: Patients with schizophrenia are at a high risk of MetS. This risk increases with age, a longer duration of illness, extended medication use, and the use of depot antipsychotics. BMI, waist circumference, and lipid profile are the most significant variables in predicting MetS. Since MetS is often asymptomatic, regular monitoring of these parameters and early recognition of MetS are essential.

Ethical Statement

Ethical approval was obtained from Van Training and Research Hospital Clinical Research Ethics Comittee with the desicion numbered 2018/04 and dated 22/04/2018.

References

  • 1.Hany M, Rehman B, Rizvi A, et al. Schizophrenia.In: StatPearls [Internet]. Treasure Island (FL):StatPearls Publishing; 2025.
  • 2.American Psychiatric Association. Diagnostic andStatistical Manual of Mental Disorders. 5th ed, textrevision. Washington, DC: American PsychiatricPublishing; 2022.
  • 3. Jauhar S, Johnstone M, McKenna PJ. Schizophrenia.Lancet. 2022;399(10323):473-86.
  • 4.Peritogiannis V, Ninou A, Samakouri M. Mortalityin schizophrenia-spectrum disorders: recentadvances in understanding and management.Healthcare (Basel). 2022;10(12):2366.
  • 5. De Hert M, Schreurs V, Vancampfort D, Van WinkelR.Metabolic syndrome in people withschizophrenia: a review. World Psychiatry.2009;8(1):15-22.
  • 6.Expert Panel on Detection, Evaluation, andTreatment of High Blood Cholesterol in Adults.Executive Summary of the third report of theNational Cholesterol Education Program (NCEP)Adult Treatment Panel III. JAMA.2001;285(19):2486-97.
  • 7.Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosisand management of the metabolic syndrome: anAmerican Heart Association/National Heart, Lung,and Blood Institute scientific statement. Circulation.2005;112(17):2735-52.
  • 8.International Diabetes Federation. The IDFconsensus worldwide definition of the metabolicsyndrome. Brussels: International DiabetesFederation; 2005.
  • 9.De Hert M, Correll CU, Bobes J, et al. Physicalillness in patients with severe mental disorders. I.Prevalence, impact of medications and disparities inhealth care. World Psychiatry. 2011;10(1):52-77.
  • 10.Mitchell AJ, Vancampfort D, Sweers K, et al.Prevalence of metabolic syndrome and metabolicabnormalities in schizophrenia and relateddisorders: a systematic review and meta-analysis.Schizophr Bull. 2013;39(2):306-18.
  • 11.Salari N, Maghami N, Ammari T, et al. Globalprevalence of metabolic syndrome in schizophreniapatients: a systematic review and meta-analysis. JPrev. 2024;45(6):973-86.
  • 12.Songur E, Karslıoğlu EH, Soygür H, et al.Metabolic syndrome in schizophrenia andschizoaffective disorder. Klin. Psikiyatr. Derg.2012;15:80-91.
  • 13.Demirkol ME, Tamam L, Çakmak S, Yeşiloğlu C.Relationship between metabolic syndrome andvitamin D levels in patients with schizophrenia.Cukurova Med J. 2019;44(3):1110-7.
  • 14.Lally J, MacCabe JH. Antipsychotic medication inschizophrenia: a review. Br Med Bull.2015;114(1):169-79.
  • 15.Stroup TS, Gray N. Management of commonadverse effects of antipsychotic medications. WorldPsychiatry. 2018;17(3):341-56.
  • 16.Yaegashi H, Kirino S, Remington G, et al.Adherence to oral antipsychotics measured byelectronic adherence monitoring in schizophrenia: asystematic review and meta-analysis. CNS Drugs.2020;34(6):579-98.
  • 17.Ozkurkcugil A, Aydemir O, Yildiz M, et al.Structured Clinical Interview for DSM-IV Axis IDisorders (SCID-I), Turkish version: reliabilitystudy. Ilac Tedavi Derg. 1999;12:233-6.
  • 18.Jones SH, Thornicroft G, Coffey M, Dunn G. A briefmental health outcome scale: reliability and validityof the Global Assessment of Functioning (GAF). Br JPsychiatry. 1995;166(5):654-9.
  • 19.Bentley-Lewis R, Koruda K, Seely EW. Themetabolic syndrome in women. Nat Clin PractEndocrinol Metab. 2007;3(10):696-704.
  • 20.De Hert M, van Winkel R, Van Eyck D, et al.Prevalence of diabetes, metabolic syndrome andmetabolic abnormalities in schizophrenia over thecourse of the illness: a cross-sectional study. ClinPract Epidemiol Ment Health. 2006;2:14.
  • 21.Mitchell AJ, Vancampfort D, De Herdt A, et al. Isthe prevalence of metabolic syndrome andmetabolic abnormalities increased in earlyschizophrenia? A comparative meta-analysis of firstepisode, untreated and treated patients. SchizophrBull. 2013;39(2):295-305.
  • 22.De Hert M, Hanssens L, Wampers M. Prevalenceand incidence rates of metabolic abnormalities anddiabetes in a prospective study of patients treatedwith second-generation antipsychotics. SchizophrBull. 2007;33(3):560.
  • 23.Carli M, Kolachalam S, Longoni B, et al. Atypicalantipsychotics and metabolic syndrome: frommolecular mechanisms to clinical differences.Pharmaceuticals (Basel). 2021;14(3):238.
  • 24.Ateem S. Metabolic syndrome monitoring inpatients on depot antipsychotics. BJPsych Open.2023;9(Suppl 1):S149.
  • 25.Nguyen T, McDonald C, Hallahan B. Theassociation of metabolic syndrome and long-actinginjectable antipsychotics: a systematic review. Eur JPsychiatry. 2022;36(3):163-75.
  • 26.Sarısoy G, Böke Ö, Öztürk A, et al. The prevalenceof metabolic syndrome in patients withschizophrenia and its relationship withsociodemographic and clinical features. DusunenAdam. 2013;26:267-75.
  • 27.Correll CU, Frederickson AM, Kane JM, Manu P.Does antipsychotic polypharmacy increase the riskfor metabolic syndrome? Schizophr Res. 2007;89(1-3):91-100.
  • 28.Tirupati S, Chua LE. Body mass index as ascreening test for metabolic syndrome inschizophrenia and schizoaffective disorders.Australas Psychiatry. 2007;15(6):470-3.
  • 29.Kato MM, Currier MB, Gomez CM, Hall L,Gonzalez-Blanco M. Prevalence of metabolicsyndrome in Hispanic and non-Hispanic patientswith schizophrenia. Prim Care Companion J ClinPsychiatry. 2004;6(2):74-7.
  • 30.Cuoco F, Agostoni G, Lesmo S, et al. Get up!Functional mobility and metabolic syndrome inchronic schizophrenia: effects on cognition andquality of life. Schizophr Res Cogn. 2022;28:100245.

Şizofreni Tanılı Hastalarda Metabolik Sendrom ve İlişkili Faktörler

Year 2025, Volume: 52 Issue: 3, 577 - 587, 16.09.2025
https://doi.org/10.5798/dicletip.1785148

Abstract

Amaç: Bu çalışma, şizofreni tanısı almış hastalarda metabolik sendrom (MetS) yaygınlığı ile ilişkili sosyodemografik ve klinik özellikleri belirlemeyi amaçlamıştır.
Yöntemler: Çalışmaya 55 şizofreni tanılı yatan hasta dahil edildi. Demografik ve klinik veri formu dolduruldu. Laboratuvar sonuçları hastane bilgi sisteminden tarandı. Hastaların boy, kilo, bel çevresi ve kan basıncı ölçümleri yapıldı. MetS tanısı, NCEP ATP III, ATP III-A (uyarlanmış) ve Uluslararası Diyabet Federasyonu (IDF) ölçütlerine göre koyuldu.
Bulgular: MetS yaygınlığı, IDF kriterlerine göre %38,2, ATP III ve ATP III-A kriterlerine göre ise %25,5 olarak bulundu. MetS tanısı alan şizofreni hastalarında ortalama yaş, hastalık süresi, ilaç kullanım süresi ve belirtilerin başlangıcı ile tanı alma arasındaki süre anlamlı olarak daha yüksekti (p<0.05). Gruplar boy, kilo ve vücut kitle indeksi (VKİ) açısından anlamlı düzeyde farklılaştı (p<0.05). MetS ölçütlerinden bel çevresi, açlık trigliserit ve açlık HDL düzeylerinde gruplar arasında anlamlı fark bulundu (p<0.05). MetS tanısı alan hastaların depo antipsikotik kullanım oranları daha yüksekti (p<0.05).
Sonuç: Şizofreni tanılı hastalar MetS açısından yüksek risk taşımaktadır. Bu riski; artan yaş, uzayan hastalık ve ilaç kullanım süresi ile depo antipsikotik kullanımı artırmaktadır. VKİ, bel çevresi ve lipid profili MetS’nin en belirleyici parametreleri olarak öne çıkmaktadır. Bu parametrelerin düzenli olarak izlenmesi ve erken dönemde tanı koyulması, MetS genellikle asemptomatik seyrettiğinden büyük önem taşımaktadır.

References

  • 1.Hany M, Rehman B, Rizvi A, et al. Schizophrenia.In: StatPearls [Internet]. Treasure Island (FL):StatPearls Publishing; 2025.
  • 2.American Psychiatric Association. Diagnostic andStatistical Manual of Mental Disorders. 5th ed, textrevision. Washington, DC: American PsychiatricPublishing; 2022.
  • 3. Jauhar S, Johnstone M, McKenna PJ. Schizophrenia.Lancet. 2022;399(10323):473-86.
  • 4.Peritogiannis V, Ninou A, Samakouri M. Mortalityin schizophrenia-spectrum disorders: recentadvances in understanding and management.Healthcare (Basel). 2022;10(12):2366.
  • 5. De Hert M, Schreurs V, Vancampfort D, Van WinkelR.Metabolic syndrome in people withschizophrenia: a review. World Psychiatry.2009;8(1):15-22.
  • 6.Expert Panel on Detection, Evaluation, andTreatment of High Blood Cholesterol in Adults.Executive Summary of the third report of theNational Cholesterol Education Program (NCEP)Adult Treatment Panel III. JAMA.2001;285(19):2486-97.
  • 7.Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosisand management of the metabolic syndrome: anAmerican Heart Association/National Heart, Lung,and Blood Institute scientific statement. Circulation.2005;112(17):2735-52.
  • 8.International Diabetes Federation. The IDFconsensus worldwide definition of the metabolicsyndrome. Brussels: International DiabetesFederation; 2005.
  • 9.De Hert M, Correll CU, Bobes J, et al. Physicalillness in patients with severe mental disorders. I.Prevalence, impact of medications and disparities inhealth care. World Psychiatry. 2011;10(1):52-77.
  • 10.Mitchell AJ, Vancampfort D, Sweers K, et al.Prevalence of metabolic syndrome and metabolicabnormalities in schizophrenia and relateddisorders: a systematic review and meta-analysis.Schizophr Bull. 2013;39(2):306-18.
  • 11.Salari N, Maghami N, Ammari T, et al. Globalprevalence of metabolic syndrome in schizophreniapatients: a systematic review and meta-analysis. JPrev. 2024;45(6):973-86.
  • 12.Songur E, Karslıoğlu EH, Soygür H, et al.Metabolic syndrome in schizophrenia andschizoaffective disorder. Klin. Psikiyatr. Derg.2012;15:80-91.
  • 13.Demirkol ME, Tamam L, Çakmak S, Yeşiloğlu C.Relationship between metabolic syndrome andvitamin D levels in patients with schizophrenia.Cukurova Med J. 2019;44(3):1110-7.
  • 14.Lally J, MacCabe JH. Antipsychotic medication inschizophrenia: a review. Br Med Bull.2015;114(1):169-79.
  • 15.Stroup TS, Gray N. Management of commonadverse effects of antipsychotic medications. WorldPsychiatry. 2018;17(3):341-56.
  • 16.Yaegashi H, Kirino S, Remington G, et al.Adherence to oral antipsychotics measured byelectronic adherence monitoring in schizophrenia: asystematic review and meta-analysis. CNS Drugs.2020;34(6):579-98.
  • 17.Ozkurkcugil A, Aydemir O, Yildiz M, et al.Structured Clinical Interview for DSM-IV Axis IDisorders (SCID-I), Turkish version: reliabilitystudy. Ilac Tedavi Derg. 1999;12:233-6.
  • 18.Jones SH, Thornicroft G, Coffey M, Dunn G. A briefmental health outcome scale: reliability and validityof the Global Assessment of Functioning (GAF). Br JPsychiatry. 1995;166(5):654-9.
  • 19.Bentley-Lewis R, Koruda K, Seely EW. Themetabolic syndrome in women. Nat Clin PractEndocrinol Metab. 2007;3(10):696-704.
  • 20.De Hert M, van Winkel R, Van Eyck D, et al.Prevalence of diabetes, metabolic syndrome andmetabolic abnormalities in schizophrenia over thecourse of the illness: a cross-sectional study. ClinPract Epidemiol Ment Health. 2006;2:14.
  • 21.Mitchell AJ, Vancampfort D, De Herdt A, et al. Isthe prevalence of metabolic syndrome andmetabolic abnormalities increased in earlyschizophrenia? A comparative meta-analysis of firstepisode, untreated and treated patients. SchizophrBull. 2013;39(2):295-305.
  • 22.De Hert M, Hanssens L, Wampers M. Prevalenceand incidence rates of metabolic abnormalities anddiabetes in a prospective study of patients treatedwith second-generation antipsychotics. SchizophrBull. 2007;33(3):560.
  • 23.Carli M, Kolachalam S, Longoni B, et al. Atypicalantipsychotics and metabolic syndrome: frommolecular mechanisms to clinical differences.Pharmaceuticals (Basel). 2021;14(3):238.
  • 24.Ateem S. Metabolic syndrome monitoring inpatients on depot antipsychotics. BJPsych Open.2023;9(Suppl 1):S149.
  • 25.Nguyen T, McDonald C, Hallahan B. Theassociation of metabolic syndrome and long-actinginjectable antipsychotics: a systematic review. Eur JPsychiatry. 2022;36(3):163-75.
  • 26.Sarısoy G, Böke Ö, Öztürk A, et al. The prevalenceof metabolic syndrome in patients withschizophrenia and its relationship withsociodemographic and clinical features. DusunenAdam. 2013;26:267-75.
  • 27.Correll CU, Frederickson AM, Kane JM, Manu P.Does antipsychotic polypharmacy increase the riskfor metabolic syndrome? Schizophr Res. 2007;89(1-3):91-100.
  • 28.Tirupati S, Chua LE. Body mass index as ascreening test for metabolic syndrome inschizophrenia and schizoaffective disorders.Australas Psychiatry. 2007;15(6):470-3.
  • 29.Kato MM, Currier MB, Gomez CM, Hall L,Gonzalez-Blanco M. Prevalence of metabolicsyndrome in Hispanic and non-Hispanic patientswith schizophrenia. Prim Care Companion J ClinPsychiatry. 2004;6(2):74-7.
  • 30.Cuoco F, Agostoni G, Lesmo S, et al. Get up!Functional mobility and metabolic syndrome inchronic schizophrenia: effects on cognition andquality of life. Schizophr Res Cogn. 2022;28:100245.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration, Medical Education, Health Services and Systems (Other)
Journal Section Original Articles
Authors

Necla Keskin

Yağmur Güzel

Publication Date September 16, 2025
Submission Date June 27, 2025
Acceptance Date September 8, 2025
Published in Issue Year 2025 Volume: 52 Issue: 3

Cite

APA Keskin, N., & Güzel, Y. (2025). Metabolic Syndrome and Related Factors in Patients with Schizophrenia. Dicle Medical Journal, 52(3), 577-587. https://doi.org/10.5798/dicletip.1785148
AMA Keskin N, Güzel Y. Metabolic Syndrome and Related Factors in Patients with Schizophrenia. Dicle Medical Journal. September 2025;52(3):577-587. doi:10.5798/dicletip.1785148
Chicago Keskin, Necla, and Yağmur Güzel. “Metabolic Syndrome and Related Factors in Patients With Schizophrenia”. Dicle Medical Journal 52, no. 3 (September 2025): 577-87. https://doi.org/10.5798/dicletip.1785148.
EndNote Keskin N, Güzel Y (September 1, 2025) Metabolic Syndrome and Related Factors in Patients with Schizophrenia. Dicle Medical Journal 52 3 577–587.
IEEE N. Keskin and Y. Güzel, “Metabolic Syndrome and Related Factors in Patients with Schizophrenia”, Dicle Medical Journal, vol. 52, no. 3, pp. 577–587, 2025, doi: 10.5798/dicletip.1785148.
ISNAD Keskin, Necla - Güzel, Yağmur. “Metabolic Syndrome and Related Factors in Patients With Schizophrenia”. Dicle Medical Journal 52/3 (September2025), 577-587. https://doi.org/10.5798/dicletip.1785148.
JAMA Keskin N, Güzel Y. Metabolic Syndrome and Related Factors in Patients with Schizophrenia. Dicle Medical Journal. 2025;52:577–587.
MLA Keskin, Necla and Yağmur Güzel. “Metabolic Syndrome and Related Factors in Patients With Schizophrenia”. Dicle Medical Journal, vol. 52, no. 3, 2025, pp. 577-8, doi:10.5798/dicletip.1785148.
Vancouver Keskin N, Güzel Y. Metabolic Syndrome and Related Factors in Patients with Schizophrenia. Dicle Medical Journal. 2025;52(3):577-8.