The Metabolic Syndrome in Patients With Severe Mental Illnesses
Prim Care Companion J Clin Psychiatry 2004;6(4):152-158
© Copyright 2015 Physicians Postgraduate Press, Inc.
Background: Since the introduction of the first
atypical antipsychotics in the early 1990s, this class of
medication has been increasingly relied upon for the treatment of
a variety of patients with psychotic and mood disorders.
Data Sources: The following retrospective review
was derived from the MEDLINE database using the search terms metabolic
syndrome, insulin resistance, obesity, diabetes, severe mental
illness, schizophrenia, bipolar disorder, mood disorders,
depression, unipolar depression, and prevalence from
1966 to the present.
Literature Synthesis: Coincident with the
growing usage of these agents, there have been a growing number
of literature reports of changes in metabolic homeostasis among
patients taking these medications. These changes have led to
interest in evaluating whether there is a relationship among
these mental illnesses, their psychiatric treatments, and certain
physical comorbidities known collectively as the metabolic
syndrome. This article reviews the existing literature around
the metabolic syndrome in patients with severe mental illnesses.
Conclusion: Patients with severe mental
illnesses, particularly schizophrenia and chronic mood disorders,
demonstrate a higher prevalence of metabolic syndrome or its
components compared with the general population. Based upon this
increased risk in these patients, baseline and periodic medical
evaluations should become a standard component in ongoing